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Wanda Jackson
NPI 1538525175 · on the registry since 2016 · sole proprietor
Practice
- Address
- 1709 L St Ne
Washington, DC 20002 - Phone
- (301) 613-5259
Registry record
- Primary taxonomy
- 374U00000X
374U00000X
- Licence states on file
- DC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2016-01-12
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 District of Columbia