Individual
ANTONINA GABRIELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1800 HOWELL MILL RD NW, SUITE 450, ATLANTA, GA 30318-2538
(404) 355-4393
(404) 419-9852
Mailing address
1800 HOWELL MILL RD NW, SUITE 450, ATLANTA, GA 30318-2538
(404) 355-4393
(404) 419-9852
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN140032 NP
GA
Other
Enumeration date
12/29/2010
Last updated
08/16/2012
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