Individual
LANITA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4819 SOUTEL DR, JACKSONVILLE, FL 32208-1856
(904) 445-0310
Mailing address
4819 SOUTEL DR, JACKSONVILLE, FL 32208-1856
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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