Individual
MELISSA RENE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, CNM
Contact information
Practice address
2744 EWING AVE S, MINNEAPOLIS, MN 55416-4213
(612) 423-1556
Mailing address
2744 EWING AVE S, MINNEAPOLIS, MN 55416-4213
(612) 423-1556
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CNM1797
MN
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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