Most Relevant Information
Provider Data
| NPI Number: | 1003670829 |
| Provider Name: | DYSHAWNICA JEARCARA JACKSON APRN CNM |
| Entity Type: | Individual |
| Taxonomy Code: | 176B00000X |
| Specialty: | Midwife |
| License Number: | 1152743 |
Most Important Dates
| Enumeration Date: | 02/12/2024 |
| Last Updated: | 02/12/2024 |
Provider Practice Location
7453 LAS COLINAS BLVD
IRVING
TX
750637561
Practice Location Phone/Fax
| Phone: | 9722156934 |
| Fax: |
Provider Mailing Location
7453 LAS COLINAS BLVD
IRVING
TX
750637561
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |