Individual
MRS. DIONNA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1145 WASHINGTON AVE, EVANSVILLE, IN 47714-1845
(812) 468-8257
(812) 468-8258
Mailing address
509 E MEADE DR, EVANSVILLE, IN 47715-3707
(812) 604-0150
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022094A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
N/A
—
Enumeration date
12/05/2020
Last updated
12/05/2020
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