Provider Demographics
NPI:1700575669
Name:JACKSON, JASMINE N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:N
Last Name:JACKSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JASMINE
Other - Middle Name:N
Other - Last Name:ALSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1102 BROOKVILLE LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6596
Mailing Address - Country:US
Mailing Address - Phone:901-734-9914
Mailing Address - Fax:
Practice Address - Street 1:612 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-9719
Practice Address - Country:US
Practice Address - Phone:919-528-4709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist