Individual
MS. JILL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-C
Contact information
Practice address
1944 ROUTE 33, SUITE 101A, NEPTUNE, NJ 07753-4862
(732) 202-8071
Mailing address
57 NORMANDIE PL, CRANFORD, NJ 07016-1957
(908) 272-8548
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00119300
NJ
Other
Enumeration date
10/24/2006
Last updated
10/17/2012
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