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Individual

NICHOLAS JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
2500 NORTH STATE ST., PREVENTIVE MEDICINE DEPARTMENT, JACKSON, MS 39216
(601) 815-8982
Mailing address
2500 NORTH STATE ST., PREVENTIVE MEDICINE DEPARTMENT, JACKSON, MS 39216
(601) 815-8982

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary

Other

Enumeration date
08/28/2020
Last updated
08/28/2020
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