Individual
MIRANDA S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9509988
FL
367500000X
Certified Registered Nurse Anesthetist
117215-23
NH
367500000X
Certified Registered Nurse Anesthetist
Primary
138117
CO
367500000X
Certified Registered Nurse Anesthetist
16896
WI
367500000X
Certified Registered Nurse Anesthetist
APRN11032969
FL
Other
Enumeration date
03/29/2020
Last updated
05/07/2026
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