Individual
JAY ALLEN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
601 HOSPITAL DR, MAQUOKETA, IA 52060-1201
(563) 652-2474
Mailing address
106 N 9TH AVE, DONAHUE, IA 52746-9800
(239) 888-3063
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
116352
IA
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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