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Individual

DEBRA A JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3450 W 34TH AVE, PINE BLUFF, AR 71603-5508
(870) 534-6067
(870) 534-7297
Mailing address
1 CHILDRENS WAY, SLOT 512-39, LITTLE ROCK, AR 72202-3500
(501) 526-8700
(501) 526-8740

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L030099
AR

Other

Enumeration date
04/12/2013
Last updated
04/12/2013
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