Individual
ANDREA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 E FRONT AVE STE 102, BISMARCK, ND 58504-5689
(701) 975-6400
(844) 670-8600
Mailing address
830 STAGECOACH CIR, BISMARCK, ND 58503-8832
(406) 672-9856
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
204935
ND
Other
Enumeration date
05/29/2026
Last updated
05/29/2026
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