Individual
YLENCIA D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 JIM MASON CT, STE A, WARNER ROBINS, GA 31088-8965
(478) 474-2947
(478) 971-4004
Mailing address
306 MEADOWRIDGE DR, STE A, WARNER ROBINS, GA 31093-2128
(478) 929-8847
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
147416
GA
Other
Enumeration date
05/23/2016
Last updated
08/02/2016
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