Individual
MRS. TERESA CLOYEDETTE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2780 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4104
(256) 533-4626
(256) 533-4710
Mailing address
2780 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4104
(256) 533-4626
(256) 533-4710
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-037414
AL
Other
Enumeration date
07/17/2009
Last updated
08/24/2021
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