Mary K Jackson, NURSE PRACTITIONER Valid NPI

Individual provider · Nurse Practitioner · Hazelwood, MO

NPI

1245358043

Type

Individual (Type 1)

Primary specialty

Nurse Practitioner

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363L00000X

License number

082648 (MO)

Sex

Female

Sole proprietor

No

Enumerated

2007-03-27

Last updated

2007-07-08