Individual
RHONDA GARY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
10420 MCKINLEY DR APT 9312, TAMPA, FL 33612-6448
(813) 340-5499
(866) 404-2708
Mailing address
10420 MCKINLEY DR APT 9312, TAMPA, FL 33612-6448
(813) 340-5499
(866) 404-2708
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP2863432
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP2863432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7857600
—
FL
01
—
P01142391
RRMCR
—
Enumeration date
12/19/2012
Last updated
05/26/2021
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