Stacey Jackson
NPI #1508301292 in Minot, North Dakota
Provider Information
- NPI Number
- 1508301292
- Entity Type
- Individual
- Name
- Stacey Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Registered Nurse
- Enumeration Date
- Jan 4, 2017
- Last Updated
- Jan 4, 2017
Practice Location
- Address
- 1015 S BROADWAY
- Address 2
- SUITE 18
- City
- Minot
- State
- North Dakota
- ZIP Code
- 58701-4667
- Phone
- (701) 857-8500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
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