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Individual

BRANDI JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
585 WOODBINE AVE, ROCHESTER, NY 14619-2039
(585) 794-8230
Mailing address
585 WOODBINE AVE, ROCHESTER, NY 14619-2039
(585) 794-8230

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
343987
NY

Other

Enumeration date
04/25/2022
Last updated
04/25/2022
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