Individual
JENNA RENAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
1501 STATE ST, MARSHALL, MN 56258-3306
(507) 537-6433
Mailing address
1103 MIDDLE ST, MEDIAPOLIS, IA 52637-9437
(319) 931-7037
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/14/2017
Last updated
07/20/2022
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