Individual
MRS. BILLIE JO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
18880 N US HIGHWAY 119, CUMBERLAND, KY 40823-8106
(606) 589-0130
Mailing address
350 RIDGE RD, BAXTER, KY 40806-8321
(606) 574-0939
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012226
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3012226
KENTUCKY BOARD OF NURSING
KY
Enumeration date
06/13/2018
Last updated
06/13/2018
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