Individual provider · Type 1 NPI
Gracie Ellen Jackson, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · South Pasadena, CA
NPI number
1255956314
Active
Practice location
625 Fair Oaks Ave Ste 300
South Pasadena, CA 91030-5805
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | NP95015149 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1255956314
Gracie Ellen Jackson, PMHNP-BC's National Provider Identifier is 1255956314, issued on Jun 14, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in South Pasadena, CA. The record was last updated on Mar 11, 2024.