Latrina Colleen Jackson, RN
Registered Nurse, Home Health in Raleigh, NC. Individual provider (NPI-1).
NPI number1669987236
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1669987236
- Entity type
- Individual (NPI-1)
- Name
- Latrina Colleen Jackson
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 5, 2017
- Last updated
- Mar 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WH0200X | Registered Nurse, Home Health | 210120 | NC | Yes |
| 163WC0400X | Registered Nurse, Case Management | 210120 | NC | |
| 163WI0500X | Registered Nurse, Infusion Therapy | 210120 | NC | |
| 163WP0808X | Registered Nurse, Psych/Mental Health | 210120 | NC |
Practice location
4922 Windy Hill Dr Ste ARaleigh, NC 27609-5196
Phone 984-200-9993 · Fax 844-747-4505
Mailing address
4922 Windy Hill Dr Ste ARaleigh, NC 27609-5196
Phone 984-200-9993 · Fax 844-747-4505
Other practice locations
4922 Windy Hill Dr Ste A
Raleigh, NC 27609-5196
Raleigh, NC 27609-5196
Phone 984-200-9993 · Fax 844-747-4505
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