Individual
MOLLY J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, CRNP
Contact information
Practice address
323 WHITETAIL DR, CHAGRIN FALLS, OH 44022-4181
(440) 338-3949
Mailing address
10900 EUCLID AVE, CLEVELAND, OH 44106-1712
(216) 368-1076
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN23078
OH
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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