Individual
RENEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
(316) 651-2961
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
(316) 651-2961
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
102563
KS
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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