Individual
CLANTRELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 S BLACKHAWK ST STE 240, AURORA, CO 80014-1475
(501) 613-7863
(580) 297-9105
Mailing address
2101 S BLACKHAWK ST STE 240, AURORA, CO 80014-1475
(501) 613-7863
(580) 297-9105
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11035553
FL
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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