Individual
NAKISA J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 TWINING ST BLDG 760, MONTGOMERY, AL 36112-6027
(334) 953-0199
Mailing address
1831 COTTON BLOSSOM WAY, PRATTVILLE, AL 36067-6631
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-065789
AL
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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