Individual
KORI DENEEN ROBERTS-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
167 N MAIN ST, TUBA CITY, AZ 86045-0600
(928) 283-2501
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60903303
WA
227800000X
Certified Respiratory Therapist
—
AZ
Other
Enumeration date
03/14/2008
Last updated
11/19/2018
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