Individual
MS. TAMIKA LACHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP, AG-ACNP
Contact information
Practice address
400 PARNASSUS AVE STE 501, SAN FRANCISCO, CA 94143-2202
(415) 353-1606
Mailing address
400 PARNASSUS AVE FL 6, SAN FRANCISCO, CA 94143-2202
(415) 353-1606
(415) 353-1213
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
22285
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
95010766
CA
363LF0000X
Family Nurse Practitioner
22285
TN
Other
Enumeration date
10/18/2018
Last updated
01/03/2019
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