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NPI Profile for VICTORIA JACKSON in BOWMAN, SC.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hemodialysis |
163WH0500X | |||
Registered Nurse |
163W00000X |
| NPI # | 1669057121 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/16/2021 | |
| Last updated | 03/16/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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VICTORIA JACKSON
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VICTORIA JACKSON