Individual
MRS. NATASHA YVONNE JACKSON-CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
756 N SUNCOAST BLVD, CRYSTAL RIVER, FL 34429-9072
(352) 346-3127
(352) 581-6226
Mailing address
756 N SUNCOAST BLVD, CRYSTAL RIVER, FL 34429-9072
(352) 346-3127
(352) 581-6226
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
RN 9355976
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11006144
FL
Other
Enumeration date
08/30/2013
Last updated
07/20/2021
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