Individual
CARLA JEAN JACKSON-HOWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
1600 N GRAND AVE, STE 530, PUEBLO, CO 81003-2700
(719) 595-7790
(719) 595-7799
Mailing address
1600 N GRAND AVE, STE 530, PUEBLO, CO 81003-2700
(719) 595-7790
(719) 595-7799
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
79051
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79051
CO LICENSE NUMBER
CO
Enumeration date
02/12/2008
Last updated
01/13/2010
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