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Individual

KATRINA JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5915 SW 49TH AVE, OCALA, FL 34474-5701
(877) 779-2429
Mailing address
127 TALLULAH AVE, JACKSONVILLE, FL 32208-4163
(904) 608-8950
(904) 768-7924

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 9329095
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11033859
FL

Other

Enumeration date
01/05/2017
Last updated
01/30/2025
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