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Individual

MS. TANYA DIANE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RNFA

Contact information

Practice address
1911 PORT LN, AMARILLO, TX 79106-2470
(806) 358-4839
(806) 358-4899
Mailing address
3016 LAGUNA DR, AMARILLO, TX 79110-3149
(806) 355-6626
(806) 358-4899

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
252294
TX

Other

Enumeration date
02/20/2007
Last updated
07/08/2007
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