Everton Jackson

NPI #1821324237 in Elmont, New York

Provider Information

NPI Number: 1821324237
Entity Type: Individual
Name: Everton Jackson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Registered Nurse
Enumeration Date: Oct 20, 2009
Last Updated: Oct 20, 2009

Practice Location

Address: 39 GOSHEN ST
City: Elmont
State: New York
ZIP Code: 11003-5024
Phone: (516) 872-5839

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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