Individual
KATHERINE JUSTINA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, WHNP-BC
Contact information
Practice address
10692 MEDLOCK BRIDGE RD STE 100A, JOHNS CREEK, GA 30097-8497
(404) 446-2496
(404) 446-2497
Mailing address
3450 BLAIR CIR NE UNIT 1408, BROOKHAVEN, GA 30319-2243
(205) 566-7869
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-190851
AL
363LW0102X
Women's Health Nurse Practitioner
Primary
GAA-NP004386
GA
Other
Enumeration date
02/19/2024
Last updated
01/13/2026
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