Individual
JEANNE MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3734 SANTIAGO CREEK WAY, ONTARIO, CA 91761-0203
(909) 582-5140
Mailing address
3734 SANTIAGO CREEK WAY, ONTARIO, CA 91761-0203
(909) 582-5140
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
705082
CA
Other
Enumeration date
02/22/2024
Last updated
02/27/2024
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