Individual
ELAINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1601 WATSON BLVD, WARNER ROBINS, GA 31093-3431
(478) 922-4281
Mailing address
83 CLIFFHAVEN CIR, NEWNAN, GA 30263-5773
(478) 972-3035
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN164249
GA
Other
Enumeration date
08/06/2025
Last updated
08/13/2025
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