Individual
MS. LUCY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7567 CALISTOGA PL, RANCHO CUCAMONGA, CA 91739-1876
(909) 899-6134
Mailing address
7567 CALISTOGA PL, RANCHO CUCAMONGA, CA 91739-1876
(909) 899-6134
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
RN530806
CA
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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