| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALRICKA JOLYNN JACKSON | 1225664212 | 2024-03-10 |
Alricka Jolynn Jackson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225664212. Registration indicates Alricka Jolynn Jackson is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, General Practice) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, General Practice) (Allopathic & Osteopathic Physicians, General Practice) (General Practice, ) (Primary Care/Family Planning/APRN/PA, ) (General Practice, Allopathic & Osteopathic Physicians)
| Entity Type | Individual |
| Provider Name | Alricka Jolynn Jackson |
| Practice Office Address | 1611 NW 12TH AVE MIAMI, FL US |
| Practice Office Telephone | 3055851111 |
| Mailing Address | 142 BERNHARD RD FAYETTEVILLE, GA 302153074 US |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 208D00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians General PracticeAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians General Practice Allopathic & Osteopathic Physicians General Practice General Practice Primary Care/Family Planning/APRN/PA General Practice Allopathic & Osteopathic Physicians | 98878
GA |