Individual
TOMEKA NICHOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6156 SAINT ANDREWS RD STE 208, COLUMBIA, SC 29212-3147
(803) 667-9012
Mailing address
119 DUTCH VILLAGE DR, IRMO, SC 29063-8718
(803) 767-0808
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22632
SC
Other
Enumeration date
08/03/2020
Last updated
03/03/2022
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