Individual
REBECCA YVETTE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2520 N CHARLES ST, BALTIMORE, MD 21218-4669
(410) 702-0510
Mailing address
2520 N CHARLES ST, BALTIMORE, MD 21218-4669
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F11200588
MD
363LF0000X
Family Nurse Practitioner
R160571
MD
Other
Enumeration date
12/05/2020
Last updated
12/20/2023
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