Individual
MICHAEL JAMES JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
19 CURTIS DR, WINDHAM, ME 04062-4704
(207) 318-4072
Mailing address
19 CURTIS DR, WINDHAM, ME 04062-4704
(207) 318-4072
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
R048931
ME
Other
Enumeration date
04/02/2016
Last updated
04/02/2016
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