Individual
MS. MARY ELIZABETH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LM
Contact information
Practice address
947 CASITAS VISTA RD, VENTURA, CA 93001-9738
(805) 649-3063
(805) 649-5418
Mailing address
947 CASITAS VISTA RD, VENTURA, CA 93001-9738
(805) 649-3063
(805) 649-5418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN416720
CA
176B00000X
Midwife
Primary
0024
CA
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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