Individual
MS. KRISTINE M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
220 W 7TH ST, DUBUQUE, IA 52001-2375
(563) 583-6431
(563) 557-4447
Mailing address
PO BOX 162, EAST DUBUQUE, IL 61025-0162
(815) 747-3932
(563) 557-4447
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
IA F 066142
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140087
—
IA
01
—
18814
WELLMARK
IA
Enumeration date
10/13/2006
Last updated
07/08/2007
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