Individual
PAYTON NICOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
217 OAK LEE DR, RANSON, WV 25438-4871
(304) 728-9041
(304) 725-2365
Mailing address
211 WIDE RIVER FARM DR, HARPERS FERRY, WV 25425-4424
(304) 820-8235
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
IN0009860
WV
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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