Individual provider · Type 1 NPI

Mary Jackson

Acute Care Nurse Practitioner · Dallas, TX

NPI number 1124419015 Active

Practice location

5201 Harry Hines Blvd
Dallas, TX 75235-7708

Mailing address

105 Wall St
Poteau, OK 74953-4433

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100X132732 (OK)
Acute Care Nurse Practitioner 363LA2100XAP127185 (TX)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1124419015

Mary Jackson's National Provider Identifier is 1124419015, issued on Feb 12, 2015. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Dallas, TX. The record was last updated on Sep 3, 2019.