Individual
MELISSA JACKSON-SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
770 WOODLANE RD, WESTAMPTON, NJ 08060-3804
(856) 881-0399
(856) 881-1033
Mailing address
801 TANGLEWOOD DR, SICKLERVILLE, NJ 08081-1161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NO12017700
NJ
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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