Organization
JACKSON'S NURSE PRACTITIONER HOUSECALLS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYSE JACKSON (MANAGING MEMBER)
(443) 255-9527
Entity
Organization
Contact information
Practice address
12 KINGS CROSSING CT APT L, COCKEYSVILLE, MD 21030
(443) 255-9527
Mailing address
12 KINGS CROSSING CT APT L, COCKEYSVILLE, MD 21030-3163
(443) 255-9527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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