Individual
MRS. DELPHIA DENT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 641-3171
Mailing address
1512 SPRY ST, GREENSBORO, NC 27405-3720
(336) 772-1510
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
116070
NC
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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