Angelique Mechelle Jackson, RN, APN-BC
Nurse Practitioner, Family in Columbia, TN. Individual provider (NPI-1).
NPI number1144599366
StatusActive
Last updated in NPPESJan 13, 2014
Details
- NPI
- 1144599366
- Entity type
- Individual (NPI-1)
- Name
- Ms. Angelique Mechelle Jackson
- Credential
- RN, APN-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 16, 2011
- Last updated
- Jan 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 16345 | TN | Yes |
Practice location
1410 Trotwood AveColumbia, TN 38401-4901
Phone 678-754-7728
Mailing address
3425 Maple Timber DrAntioch, TN 37013-5453
Phone 678-754-7728
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