Individual
MS. ANITA JUNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(800) 996-7566
Mailing address
5806 MEADOW BROOK CT, SAINT JOSEPH, MO 64503-2302
(816) 752-6556
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
2014008537
MO
Other
Enumeration date
04/26/2014
Last updated
04/26/2014
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