Individual
KATHLEEN EARLY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10660 PARK RD STE 3100, CHARLOTTE, NC 28210-8420
(803) 329-3130
Mailing address
10660 PARK RD STE 3100, CHARLOTTE, NC 28210-8420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13726
NC
Other
Enumeration date
10/26/2016
Last updated
03/27/2025
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