Individual
HEATHER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
960 E LEE ST, WASILLA, AK 99654-0502
(907) 775-5593
Mailing address
1365 E PARKS HWY STE 101, WASILLA, AK 99654-8297
(907) 357-6445
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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