Individual
KATHERINE ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP-PC
Contact information
Practice address
1238 DANTIGNAC ST, AUGUSTA, GA 30901-2788
(706) 922-0600
Mailing address
PO BOX 31164, AUGUSTA, GA 30903-2964
(706) 922-0600
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN184943
GA
Other
Enumeration date
07/28/2022
Last updated
04/01/2025
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