Gina Lori Jackson, RN
Registered Nurse, Psych/Mental Health, Adult in Alexandria, VA. Individual provider (NPI-1).
NPI number1659487809
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1659487809
- Entity type
- Individual (NPI-1)
- Name
- Ms. Gina Lori Jackson
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 0001086096 | VA | Yes |
Practice location
8119 Holland RdPact
Alexandria, VA 22306-3135
Phone 703-799-2762 · Fax 703-780-6928
Mailing address
8616 Shadwell Dr67
Alexandria, VA 22309-4634
Phone 703-360-0338
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