Individual provider · Type 1 NPI
Carla Marie Jackson, APRN
Primary Care Nurse Practitioner · Fulton, AR
NPI number
1710694971
Active
Practice location
4903 Highway 67 W
Fulton, AR 71838-9033
Mailing address
PO Box 7395
Texarkana, TX 75505-7395
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Infusion Therapy Clinic/Center | 261QI0500X | 1036336 (TX) |
| Primary Care Clinic/Center | 261QP2300X | 1036336 (TX) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 1036336 (TX) |
Primary Care Nurse Practitioner: Definition to come...
About NPI 1710694971
Carla Marie Jackson, APRN's National Provider Identifier is 1710694971, issued on Oct 27, 2022. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fulton, AR. The record was last updated on Oct 27, 2022.