Individual
CATHERINE MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNAP, CRNA
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2444
Mailing address
178 TRAIL LOOP DR UNIT 103, PADUCAH, KY 42001-4063
(573) 380-9114
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4030583
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
4030583
KY
Other
Enumeration date
12/04/2024
Last updated
01/15/2025
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