Individual
SUSAN L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
777 BANNOCK ST, MC 7782, DENVER, CO 80204-4507
(303) 436-6000
Mailing address
777 BANNOCK ST, MC 7782, DENVER, CO 80204-4507
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
97059
CO
Other
Enumeration date
07/28/2006
Last updated
03/09/2021
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