Individual
JESSICA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
5323 4TH AVENUE CIR E, BRADENTON, FL 34208-5623
(941) 745-5115
Mailing address
5323 4TH AVENUE CIR E, BRADENTON, FL 34208-5623
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
11031449
FL
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN11031449
FL
Other
Enumeration date
02/23/2024
Last updated
06/05/2024
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