Individual
KATRINA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
34 NASHUA ST, FITCHBURG, MA 01420-5713
(978) 868-0876
Mailing address
34 NASHUA ST, FITCHBURG, MA 01420-5713
(978) 868-0876
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN101034
MA
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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