Individual
MARILYN K JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
335 S PAPA AVE, KAHULUI, HI 96732-1528
(808) 944-2882
Mailing address
143 HOOWAIWAI LOOP APT 2801, WAILUKU, HI 96793-4134
(808) 250-6543
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
72652
HI
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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