Individual
JANEIRA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6000
Mailing address
1537 E PASTORIUS ST, PHILADELPHIA, PA 19138-1622
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN764624
PA
Other
Enumeration date
04/27/2024
Last updated
04/27/2024
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