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Individual

MELISSA B JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
129 FOUNTAINS BLVD STE 101, MADISON, MS 39110-6344
(769) 300-0700
Mailing address
PO BOX 54024, PEARL, MS 39288-4024
(601) 624-6552

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902231
MS

Other

Enumeration date
11/16/2017
Last updated
11/16/2017
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