Individual
MRS. CYNTHIA L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
(913) 758-4119
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
(913) 758-4119
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1346066122
KS
Other
Enumeration date
05/09/2006
Last updated
07/16/2007
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