Provider Demographics
NPI:1881922433
Name:JACKSON, JAMIE BROWN (CD, PCD)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:BROWN
Last Name:JACKSON
Suffix:
Gender:F
Credentials:CD, PCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CENTER PARK WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4112
Mailing Address - Country:US
Mailing Address - Phone:919-387-3705
Mailing Address - Fax:
Practice Address - Street 1:311 CENTER PARK WAY
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4112
Practice Address - Country:US
Practice Address - Phone:919-387-3705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula