Individual
LAURYN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6470 S HIGLEY RD, GILBERT, AZ 85298-4341
(480) 809-2409
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
(615) 425-4200
(615) 425-4201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10391
AZ
363AM0700X
Medical Physician Assistant
Primary
10391
AZ
Other
Enumeration date
05/08/2024
Last updated
06/25/2025
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