Individual
MS. COURTNEY TAMARA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
407 COWART AVE, VALDOSTA, GA 31602-2635
(229) 242-1187
Mailing address
5380 JACKSON RD, MORVEN, GA 31638-3935
(229) 292-6275
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F09200417
GA
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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