Individual
SUE ANN JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1515 E BROAD ST, COLUMBUS, OH 43205-1550
(614) 252-0711
Mailing address
10428 APPLETON RD, JOHNSTOWN, OH 43031-9389
(614) 252-0711
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
239988
OH
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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