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Individual

TERI DANIELLE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
18 RIVERBEND DR SW STE 100, ROME, GA 30161-6019
(706) 314-1900
Mailing address
18 RIVERBEND DR SW STE 100, ROME, GA 30161-6019
(706) 314-1900

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN268351
GA

Other

Enumeration date
02/15/2022
Last updated
12/05/2023
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