Individual
PROF. CRAIG LEBERN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4297 WYNDAM HILL DR, SUWANEE, GA 30024-6525
(404) 294-0499
Mailing address
4297 WYNDAM HILL DR, SUWANEE, GA 30024-6525
(404) 294-0499
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
148363
GA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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