Individual
JACKIE LYNN EBERSOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1605 S FRANCISCO CT, ANTIOCH, CA 94509-5352
(925) 813-3337
(925) 813-3331
Mailing address
1605 S FRANCISCO CT, ANTIOCH, CA 94509-5352
(925) 813-3337
(925) 813-3331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
462648
CA
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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