Individual
MRS. ANGELIA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
5129 DIXIE HWY, LOUISVILLE, KY 40216-1727
(502) 447-3242
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3008402
KY
363LF0000X
Family Nurse Practitioner
Primary
3008402
KY
Other
Enumeration date
12/07/2013
Last updated
03/30/2023
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