Individual
MRS. KATHY MELTON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
6051 WESCOTT RD, COLUMBIA, SC 29212-1408
(803) 476-3609
(803) 476-3620
Mailing address
6051 WESCOTT RD, COLUMBIA, SC 29212-1408
(803) 476-3609
(803) 476-3620
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
29074
SC
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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