Individual
MRS. KIMBERLY CHENAULT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 FAIRWAY DR, MILLBROOK, AL 36054-1846
(334) 322-4886
Mailing address
222 FAIRWAY DR, MILLBROOK, AL 36054-1846
(334) 322-4886
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-170200
AL
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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