Individual
CHRISTA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1510 E RUSHOLME ST, DAVENPORT, IA 52803-2463
(563) 336-3000
(563) 344-1371
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3125
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
G179008
IA
367A00000X
Advanced Practice Midwife
Primary
B118673
IA
Other
Enumeration date
10/01/2010
Last updated
07/10/2024
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