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Individual

MRS. JULIE M JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
725 AMERICAN AVE, INTERVENTIONAL PAIN, WAUKESHA, WI 53188-5031
(262) 928-8672
Mailing address
725 AMERICAN AVE, INTERVENTIONAL PAIN, WAUKESHA, WI 53189
(262) 928-8672

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4653-33
WI

Other

Enumeration date
11/28/2011
Last updated
11/28/2011
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