Individual
SHELLI M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2602 WILMINGTON RD STE 200, NEW CASTLE, PA 16105-1538
(724) 657-3204
(724) 652-7144
Mailing address
2602 WILMINGTON RD STE 200, NEW CASTLE, PA 16105-1538
(724) 657-3204
(724) 652-7144
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP012348
PA
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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