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Individual

WYKESHIA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9602 MEADE CIR N, OLIVE BRANCH, MS 38654-3780
(662) 544-7468
Mailing address
9602 MEADE CIR N, OLIVE BRANCH, MS 38654-3780
(662) 544-7468

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906024
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
906024
MS

Other

Enumeration date
01/22/2024
Last updated
04/30/2026
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