Individual
ANTONIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 N BROOKWOOD AVE, HAMILTON, OH 45013-1209
(139) 814-2035
Mailing address
1 N BROOKWOOD AVE, HAMILTON, OH 45013-1209
(139) 814-2035
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
398426
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0030393
OH
Other
Enumeration date
01/07/2014
Last updated
04/29/2025
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