Individual
MAYBELLE F. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
45 SARAGOSSA RD, NATCHEZ, MS 39120-8663
(601) 445-9942
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R672947
MS
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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