Individual
MILLISON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4929 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 871-6122
(414) 871-2552
Mailing address
4929 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 871-6122
(414) 871-2552
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
156345-30
WI
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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