Suyapa Mariel Jackson, NP Valid NPI

Individual provider · Primary Care Nurse Practitioner · Tontitown, AR

NPI

1659105195

Type

Individual (Type 1)

Primary specialty

Primary Care Nurse Practitioner (Nurse Practitioner)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363LP2300X

License number

906658 (MS)

Sex

Female

Sole proprietor

No

Enumerated

2024-08-28

Last updated

2024-08-28