Individual provider · Type 1 NPI
Ronica Jackson, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Fort Wayne, IN
NPI number
1780412783
Active
Practice location
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Mailing address
PO Box 392552
Pittsburgh, PA 15251-9500
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 28208894A (IN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1780412783
Ronica Jackson, PMHNP's National Provider Identifier is 1780412783, issued on Jul 23, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 23, 2024.