Individual
MS. LEBERTA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CERTIFIED TRICHO
Contact information
Practice address
21 E. CHOCCOLOCCO STREET, OXFORD, AL 36203-1215
(256) 835-0759
Mailing address
P.O. BOX 3017, OXFORD, AL 36203-0017
(256) 835-0759
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-098453
AL
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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