Individual
LAVETT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2188 58TH ST N, CLEARWATER, FL 33760-3112
(727) 327-7656
(727) 322-2142
Mailing address
2188 58TH ST N, CLEARWATER, FL 33760-3112
(727) 327-7656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9372455
FL
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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