Individual
LATRESHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7758 PLEASANT VALLEY DR, HARRISBURG, NC 28075-6699
(704) 277-9996
Mailing address
7758 PLEASANT VALLEY DR, HARRISBURG, NC 28075-6699
(704) 277-9996
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
183196
NC
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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