MR. Phillip Anthony Jackson JR., CRNP

NPI #1992435036 in Baltimore, Maryland

Provider Information

NPI Number: 1992435036
Entity Type: Individual
Name: MR. Phillip Anthony Jackson JR., CRNP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Nurse Practitioner
Credential: CRNP
Enumeration Date: Jun 13, 2022
Last Updated: Jun 13, 2022

Practice Location

Address: 22 S GREENE ST
City: Baltimore
State: Maryland
ZIP Code: 21201-1544
Phone: (410) 328-8667

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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