Individual
PAULA DEAUN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
160 E ERIE AVE STE 3311, PHILADELPHIA, PA 19134-1011
(215) 427-3803
(215) 492-8119
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-1324
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
TP004745D
PA
363LC1500X
Community Health Nurse Practitioner
26NJ00025500
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP030377
PA
Other
Enumeration date
11/07/2005
Last updated
12/15/2025
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