Individual
MS. HAZEL ANITA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MN, RN, APRN,BC
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 327-4972
Mailing address
1429 OAK KNOLL DR NE, CONYERS, GA 30012-4751
(770) 918-1558
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R084397
GA
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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