Individual
ANDRA NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4860 STONE MOUNTAIN HWY, LILBURN, GA 30047-4618
(770) 972-2846
Mailing address
3222 CHADWICK CT, CONYERS, GA 30013-6485
(470) 426-2023
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH035880
GA
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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