Individual
MRS. ETOSHIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-6286
Mailing address
6208 JOY BLVD S, HORN LAKE, MS 38637-2462
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26787
TN
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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