Individual
MRS. CARRIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN SANE-A
Contact information
Practice address
4573 BELFAST DR, COLUMBUS, OH 43227-2528
(740) 294-5963
Mailing address
4573 BELFAST DR, COLUMBUS, OH 43227-2528
(740) 294-5963
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
329817
OH
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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