Individual
SANDRA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6965 N 90TH ST, OMAHA, NE 68122-5230
(402) 590-3168
Mailing address
6965 N 90TH ST, OMAHA, NE 68122-5230
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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