Individual
ANIKA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1833 3RD AVE, ANOKA, MN 55303-2424
(612) 924-3807
Mailing address
16955 TORONTO AVE SE, PRIOR LAKE, MN 55372-3055
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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