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Individual

MARSHA E JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1501 KING ST, ALEXANDRIA, VA 22314-2716
(703) 549-5070
(703) 549-4821
Mailing address
12400 MARTIN RD, BRANDYWINE, MD 20613-8745
(301) 372-6214
(301) 372-1585

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
0024105852
VA
367A00000X
Advanced Practice Midwife
R082221
MD
367A00000X
Advanced Practice Midwife
RN33128
DC

Other

Enumeration date
03/07/2007
Last updated
07/08/2007
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