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Individual

LORI ANNE JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
Mailing address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2006033813
MO

Other

Enumeration date
10/10/2011
Last updated
10/10/2011
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