Individual
MRS. RENA ROSETT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 ELIZABETH DR, CLINTON, MS 39056-6139
(601) 456-9799
Mailing address
100 ELIZABETH DR, CLINTON, MS 39056-6139
(601) 456-9799
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
893821
MS
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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