Individual
BEATRICE KASEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
901 W HICKORY ST, DEMING, NM 88030-4046
(755) 546-2174
Mailing address
901 W HICKORY ST, DEMING, NM 88030-4046
(575) 546-2174
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
07/06/2022
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