Individual
JOEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4301 X STREET, SACRAMENTO, CA 95817
(419) 953-4775
Mailing address
4012 SAN MARINO ST, DAYTON, OH 45440
(419) 953-4775
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.0021045
OH
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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