Individual
EBONY ADELE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1198 S GOVERNORS AVE STE 201, DOVER, DE 19904-6930
(302) 382-8698
(302) 269-3800
Mailing address
1198 S GOVERNORS AVE STE 201, DOVER, DE 19904-6930
(302) 382-8698
(302) 269-3800
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
L8-0010677
DE
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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