Individual
TE'ESSENCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
270683
NC
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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