Individual
DEMETRICE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1823 HAMILTON ST, QUINCY, FL 32351-4101
(850) 296-4388
Mailing address
1823 HAMILTON ST, QUINCY, FL 32351-4101
(850) 296-4388
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9345149
FL
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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