Individual
MS. TAMEATRICE MICHELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN/CRT
Contact information
Practice address
2506 CHESTNUT SPRINGS LN, JACKSONVILLE, FL 32246-1323
(904) 382-1793
(904) 253-6759
Mailing address
2506 CHESTNUT SPRINGS LN, JACKSONVILLE, FL 32246-1323
(904) 382-1793
(904) 253-6759
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
RN9255446
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693464196
—
FL
Enumeration date
05/16/2008
Last updated
05/16/2008
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