Individual
ANGELA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2717 S 88TH ST, OMAHA, NE 68124-3048
(402) 614-0413
Mailing address
2717 S 88TH ST, OMAHA, NE 68124-3048
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
07/09/2026
Last updated
07/09/2026
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