Tana Jackson-Wilson
Tana Jackson-Wilson is a Licensed Practical Nurse in Phoenix, Arizona. Licensed in Arizona and Illinois. Registered with an NPI since 2013.
- Licensed in
- AZ, IL
- In the registry since
- 2013
- Specialties on file
- 2
Practice location Address checks out
4612 N 28th St Camelback Hs Medically FragilePhoenix, AZ 85016-4931
Phone: (602) 764-7122
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Specialties & licences
| Licensed Practical Nurse (primary) | Taxonomy 164W00000X · Licence LP048815 (AZ) |
|---|---|
| Licensed Practical Nurse | Taxonomy 164W00000X · Licence 043114639 (IL) |
Record details
| NPI number | 1639504152 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 4, 2013 |
| Last updated in NPPES | September 4, 2013 |
| Mailing address | 4612 N 28th St, Camelback Hs Medically Fragile, Phoenix, AZ 85016-4931 |
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