Individual provider · Type 1 NPI
Carmella Jackson
Family Nurse Practitioner · Matteson, IL
NPI number
1336782200
Active
Practice location
916 School Ave
Matteson, IL 60443-1832
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 209020232 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1336782200
Carmella Jackson's National Provider Identifier is 1336782200, issued on Oct 23, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Matteson, IL. The record was last updated on Oct 23, 2019.