Individual
MRS. HANNAH STEWART JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-2000
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5015589
NC
363LA2100X
Acute Care Nurse Practitioner
5015589
NC
363LA2200X
Adult Health Nurse Practitioner
5015589
NC
363LG0600X
Gerontology Nurse Practitioner
5015589
NC
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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