Individual
MRS. SUSANNE SOCHA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 ERWIN RD, DURHAM, NC 27710-0001
(919) 688-3079
(919) 688-8049
Mailing address
804 W TRINITY AVE, DURHAM, NC 27701-1826
(919) 688-3079
(919) 688-8049
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201136
NC
Other
Enumeration date
09/02/2006
Last updated
01/31/2008
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