Individual
MRS. JESSICA LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9201 UNIVERSITY CITY BLVD STUDENT HEALTH, CHARLOTTE, NC 28223-0328
(704) 687-7403
(704) 687-1801
Mailing address
PO BOX 601067, CHARLOTTE, NC 28260-1067
(704) 801-1000
(704) 896-2961
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5005386
NC
363LF0000X
Family Nurse Practitioner
207353
NC
363LF0000X
Family Nurse Practitioner
Primary
5005386
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700163771
—
NC
05
—
7006167
—
NC
05
—
NP2522
—
SC
Enumeration date
11/04/2011
Last updated
09/19/2024
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