Individual
MS. GINA LORI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8119 HOLLAND RD, PACT, ALEXANDRIA, VA 22306-3135
(703) 799-2762
(703) 780-6928
Mailing address
8616 SHADWELL DR, 67, ALEXANDRIA, VA 22309-4634
(703) 360-0338
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0001086096
VA
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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