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Individual

MS. SANDRA F JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
23 W 37TH ST, WILMINGTON, DE 19802-2225
(302) 450-4551
(302) 355-2550
Mailing address
23 W 37TH ST, WILMINGTON, DE 19802-2225
(302) 450-4551
(302) 355-2550

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP008227
PA
363LF0000X
Family Nurse Practitioner
LG-0000519
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1396717286 363L00000
DE
Enumeration date
02/03/2006
Last updated
06/23/2020
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