Individual
MRS. JAMI VICTORIA DAVIS-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP BC
Contact information
Practice address
1 SAINT ANTHONYS WAY, ALTON, IL 62002-4568
(314) 317-0600
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2001031602
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
209-007873
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629243886
—
IL
05
—
1629243886
—
MO
Enumeration date
04/28/2008
Last updated
04/22/2014
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