Individual
REBECCA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
55 WHITCHER ST NE STE 260, MARIETTA, GA 30060-1169
(943) 202-7050
(470) 986-7016
Mailing address
55 WHITCHER ST NE STE 260, MARIETTA, GA 30060-1169
(943) 202-7050
(470) 986-7016
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
297784
GA
Other
Enumeration date
01/03/2022
Last updated
09/06/2023
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