Most Relevant Information
Provider Data
| NPI Number: | 1003244864 |
| Provider Name: | PAMELA JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/14/2013 |
| Last Updated: | 10/14/2013 |
Provider Practice Location
MAIN STREET
EAGLE
AK
99738
Practice Location Phone/Fax
| Phone: | 9075472281 |
| Fax: |
Provider Mailing Location
MAIN STREET
EAGLE
AK
99738
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |