Individual
TALESHA MICHELL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4900 MILLENIA BLVD APT 307, ORLANDO, FL 32839-6052
(321) 427-7887
Mailing address
4900 MILLENIA BLVD APT 307, ORLANDO, FL 32839-6052
(321) 427-7887
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11002223
FL
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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