Individual
CHRISTINE S JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2693 NORTH ST, BEAUMONT, TX 77702-1624
(409) 832-8862
(409) 832-1664
Mailing address
2693 NORTH ST, BEAUMONT, TX 77702-1624
(409) 832-8862
(409) 832-1664
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP125323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353166701
—
TX
Enumeration date
04/01/2014
Last updated
12/14/2023
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