Individual
JENICA J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3101 N 11TH ST, BISMARCK, ND 58503-0594
(701) 224-9521
(701) 224-1360
Mailing address
3101 N 11TH ST, BISMARCK, ND 58503-0594
(701) 224-9521
(701) 224-1360
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5252
ND
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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