Individual
MS. BECKY DIXON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE ANESTHETIST
Contact information
Practice address
302 UNIVERSITY PKWY, ANESTHESIA DEPARTMENT, AIKEN, SC 29801-6302
(336) 553-1659
(336) 553-3994
Mailing address
PO BOX 7397, AIKEN, SC 29804-7397
(336) 553-1659
(336) 553-3994
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2782
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0576
—
SC
Enumeration date
09/01/2006
Last updated
11/29/2007
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