Individual
MS. JOYCE JACQUETTA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3450 OLD WASHINGTON ROAD, SUITE 202, WALDORF, MD 20602-3248
(301) 645-3590
(301) 705-1941
Mailing address
3450 OLD WASHINGTON ROAD, SUITE 202, WALDORF, MD 20602-3248
(301) 645-3590
(301) 705-1941
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024167148
VA
363L00000X
Nurse Practitioner
622905
CA
363L00000X
Nurse Practitioner
Primary
R109047
MD
Other
Enumeration date
02/14/2008
Last updated
02/14/2008
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