Individual
MRS. GLENDA S JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN C
Contact information
Practice address
1701 HARDEE AVE, FORT MCPHERSON, GA 30330
(404) 464-0266
(404) 464-0475
Mailing address
1741 CEDAR WALK LN, CONLEY, GA 30288-1745
(404) 361-0853
(404) 464-0475
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN083685
GA
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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