Individual
MAYELA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 RIM RD STE 300, EL PASO, TX 79902-3669
(915) 533-7465
Mailing address
1720 MURCHISON DR, EL PASO, TX 79902-2921
(915) 533-7465
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
761460
TX
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
761460
TX
Other
Enumeration date
04/22/2011
Last updated
06/24/2022
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