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NPI Profile for JANICE L JACKSON in GULFPORT, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X |
| NPI Number | 1467280925 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/24/2024 | |
| Last updated | 07/24/2024 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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JANICE L JACKSON
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JANICE L JACKSON