Individual
INAISHA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
RUTGERS, UNIVERSITY BEHAVIORAL HEALTH CARE, BATES BUILDING, 2ND FLOOR, TRENTON, NJ 08625-863
(609) 292-9700
Mailing address
5450 WISSAHICKON AVE APT A1103, PHILADELPHIA, PA 19144-5261
(862) 520-9487
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00625000
NJ
Other
Enumeration date
03/16/2016
Last updated
08/16/2018
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