Individual
TINA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
300 KEISLER DRIVE, SUITE 204, CARY, NC 27518
(919) 233-0059
(919) 233-0343
Mailing address
1525 CRICKETT RD, RALEIGH, NC 27610-9327
(919) 266-6565
(919) 233-0343
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
900192
NC
Other
Enumeration date
03/13/2007
Last updated
08/08/2024
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