Individual
MS. JULIE A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7240
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7240
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015004290
MO
363LF0000X
Family Nurse Practitioner
Primary
209012810
IL
Other
Enumeration date
03/25/2015
Last updated
08/11/2022
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