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NPI Profile for SHANNON L JACKSON in DURHAM, NC.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
163WP0200X |
| NPI Number | 1235766601 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 03/25/2020 | |
| Last updated | 03/25/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHANNON L JACKSON
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SHANNON L JACKSON, RN