Individual
VANESSA RACHEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDM
Contact information
Practice address
728 GAFFNEY RD, SUITE 100, FAIRBANKS, AK 99701-4610
(907) 456-3719
(907) 456-1511
Mailing address
728 GAFFNEY RD, SUITE 100, FAIRBANKS, AK 99701-4610
(907) 456-3719
(907) 456-1511
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
AA42
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA42
CDM
AK
05
—
NM0042
—
AK
Enumeration date
03/14/2007
Last updated
11/06/2012
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