Individual
BRANDY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
895 N MAIN ST, MONTICELLO, KY 42633-1580
(606) 396-3006
Mailing address
447 ASPEN DR, LONDON, KY 40741-8246
(606) 312-9398
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013927
KY
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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