Individual provider · Type 1 NPI
Candice Jackson
Administrator Registered Nurse · Richmond, TX
NPI number
1174778393
Active
Practice location
1235 Blue Leaf Dr
Richmond, TX 77469-6255
Fax (281) 754-4393
Mailing address
PO Box 701
Richmond, TX 77406-0018
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse Primary | 163WA2000X | 009445 (TX) |
Administrator Registered Nurse: Definition to come...
Another provider at this address
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About NPI 1174778393
Candice Jackson's National Provider Identifier is 1174778393, issued on Dec 2, 2008. The primary taxonomy on file is Administrator Registered Nurse (163WA2000X), and the practice location is in Richmond, TX. The record was last updated on Dec 9, 2008.