Individual
KRYSTLE STARR MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8701 BROADWAY, MERRILLVILLE, IN 46410-7035
(219) 738-5510
Mailing address
5433 VAN BUREN ST, MERRILLVILLE, IN 46410-1460
(765) 461-3366
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28208846A
IN
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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