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Melissa Jackson, RN

Registered Nurse, General Practice in Saint Paul, MN. Individual provider (NPI-1).

NPI number1023834371
StatusActive
Last updated in NPPESDec 2, 2024

Details

NPI
1023834371
Entity type
Individual (NPI-1)
Name
Melissa Jackson
Credential
RN
Sex
Female
Sole proprietor
No
Enumeration date
Dec 2, 2024
Certification date
Dec 2, 2024
Last updated
Dec 2, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice1850152MNYes

Practice location

640 Jackson St
Saint Paul, MN 55101-2502

Phone 651-254-1611

Mailing address

640 Jackson St
Saint Paul, MN 55101-2502

Phone 651-254-1611

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