NPI 1013482439

Pamela Kenna Jackson

Practitioner Driver Union, NJ

Practice location

Address: 1496 Village Rd APT a, Union, NJ 07083-4461
Phone: (201) 284-2307

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence J00626147258862 (NJ)

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Registry record

NPI: 1013482439
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Oct 2018
Record last updated: 9 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.