Individual
JACKIE KERSEY-HARDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 IMPERIAL AVE, SAN DIEGO, CA 92101-7493
(619) 338-2888
Mailing address
1255 IMPERIAL AVE, SAN DIEGO, CA 92101-7493
(619) 338-2888
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
520318
CA
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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