Individual
MARSHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5600 NW 57TH WAY, TAMARAC, FL 33319-2420
(954) 471-9220
Mailing address
5600 NW 57TH WAY, TAMARAC, FL 33319-2420
(954) 471-9220
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
9236954
FL
363LP2300X
Primary Care Nurse Practitioner
9236954
FL
Other
Enumeration date
01/10/2021
Last updated
02/05/2021
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