Individual
MR. CHARLES E. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
8260 WILLOW OAKS CORPORATE DR STE 650, FAIRFAX, VA 22031-4531
(703) 776-2000
(571) 665-6797
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024178860
VA
363LF0000X
Family Nurse Practitioner
5007190
NC
363LF0000X
Family Nurse Practitioner
RN1049831
DC
Other
Enumeration date
09/22/2014
Last updated
05/06/2026
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