Individual
MS. ANN CLARA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3080 S STRATTON DR, WEST ALLIS, WI 53219-2762
(414) 758-5635
Mailing address
N52W21801 VIRGINIA LN, MENOMONEE FALLS, WI 53051-6224
(262) 735-8085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
105121-030
WI
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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