Individual
CHERYSE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 KINGS CROSSING CT, APT L, COCKEYSVILLE, MD 21030-3172
(443) 255-9527
Mailing address
12 KINGS CROSSING COURT, L, COCKEYSVILLE, MD 21030
(443) 255-9527
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R204022
MD
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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