Individual
WENDY ANNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 THOMPSON INN RD, SOUTH BRISTOL, ME 04568-4300
(207) 370-2785
Mailing address
5 THOMPSON INN RD, SOUTH BRISTOL, ME 04568-4300
(207) 370-2785
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
015841
ME
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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