Mr. Larry Randolph Jackson, REGISTEREDNURSE
Mr. Larry Randolph Jackson, REGISTEREDNURSE is a Psychiatric/Mental Health Registered Nurse in Columbia, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.
- Licensed in
- SC
- In the registry since
- 2006
Practice location Address checks out
615 Rapids RdColumbia, SC 29212-3024
Phone: (803) 798-2211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Registered Nurse (primary) | Taxonomy 163WP0808X · Licence 56879 (SC) |
|---|
Record details
| NPI number | 1093878191 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | REGISTEREDNURSE |
| Sole proprietor | Yes |
| NPI enumerated | December 19, 2006 |
| Last updated in NPPES | July 8, 2007 |
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