Individual
MS. TARJILYN M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN,RN
Contact information
Practice address
2613 AVENIDO DEL PINAR ST, GAUTIER, MS 39553-6838
(228) 623-8312
Mailing address
2613 AVENIDO DEL PINAR ST, GAUTIER, MS 39553-6838
(228) 623-8312
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
909409
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2613
WORK RELATED
MS
Enumeration date
01/04/2021
Last updated
01/04/2021
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