Individual
KRISTINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
114 SANDHILL DR, SUITE 101, MIDDLETOWN, DE 19709-5805
(203) 378-4779
(302) 378-3789
Mailing address
114 SANDHILL DR, SUITE 101, MIDDLETOWN, DE 19709-5805
(203) 378-4779
(302) 378-3789
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
LG-000450
DE
Other
Enumeration date
01/29/2009
Last updated
03/04/2013
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