Individual
MISS KATHRYN M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
235 ALPHA DR, SUITE 101, PITTSBURGH, PA 15238-2940
(877) 868-4827
(877) 283-0663
Mailing address
235 ALPHA DR, SUITE 101, PITTSBURGH, PA 15238-2940
(877) 868-4827
(877) 283-0663
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
66815-600034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190482
MEDCOST
NC
01
—
2630370
UHC
NC
05
—
7003842
—
NC
Enumeration date
05/31/2006
Last updated
11/30/2010
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