Search › New Mexico › 104100000X
Tina Jackson, LCSW
NPI 1376968172 · on the registry since 2014
Practice
- Address
- 280 1st St Bldg 23
Holloman Afb, NM 88330 - Phone
- (575) 572-5676
- Fax
- (575) 572-1523
- Organisation at this address
- 49th Medgrp-Holloman
49th Medgrp-HollomanInferred from a shared address, not stated in the registry. - Clinicians at this address
- 34
Additional practice sites
- 16351 I94, Sentinel Butte, ND
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- ND
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-07-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico