Individual
MRS. DONNA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4383 N 27TH ST, MILWAUKEE, WI 53216-1809
(414) 871-8883
(414) 871-8950
Mailing address
4383 N 27TH ST, MILWAUKEE, WI 53216-1809
(414) 871-8883
(414) 871-8950
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30476-031
WI
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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