Individual
MRS. MIRIAM M JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
7940 SHOAL CREEK BLVD STE 100, AUSTIN, TX 78757-7589
(512) 494-4000
(512) 494-4024
Mailing address
7940 SHOAL CREEK BLVD STE 100, AUSTIN, TX 78757-7589
(512) 494-4000
(512) 494-4024
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP123315
TX
Other
Enumeration date
03/14/2013
Last updated
06/10/2021
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