Tonya L. Jackson

NPI 1235467945 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1235467945
Gender Female
Enumeration Date 11/19/2009
Last Updated 11/19/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
3401 N 67TH AVE
PHOENIX AZ, 85033-4517, US
Phone (623) 691-4085
Fax
Business Location
561 N. SIRRINE ST.
MESA AZ, 85201, US
Phone
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Arizona
License Number LP965595
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According to our database, Ms. Tonya L. Jackson NPI is 1235467945, taxonomy code is 164W00000X and license number is LP965595, license state is located at Arizona. Tonya L. Jackson physically located at 3401 N 67th Ave, Phoenix AZ, 85033-4517. NPI Number Tonya L. Jackson has the Individual type.

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1235467945 NPI number is provided on an as is basis without warranty of any kind. 1235467945 is maintained by the National Plan & Provider Enumeration System. The contents of Tonya L. Jackson are for informational purposes only.