Individual
WILBERTA D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
750 BISON STREET, KOTZEBUE, AK 99752
(907) 442-7144
Mailing address
PO BOX 170, KOTZEBUE, AK 99752-0170
(907) 442-7243
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
115503
AK
Other
Enumeration date
11/30/2016
Last updated
12/20/2016
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