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Willie Jackson
NPI 1841571478 · on the registry since 2011 · sole proprietor
Practice
- Address
- 5304 Roseland Ave
Las Vegas, NV 89130 - Phone
- (702) 630-5009
- Fax
- (702) 631-9821
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Licence states on file
- NV
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-10-18
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 Nevada