Dr CHANELLE C JACKSON is a female medical professional, specializing in Nurse Practitioner. She graduated in 2016.
WAL-MART STORES EAST LP
2240 W DEKALB ST
CAMDEN
SC
290202069
Tel: 8039006028
| Npi | 1629510862 |
| Pac Id | 5496031569 |
| Professional Enrollment Id | I20170405000041 |
| Last Name | JACKSON |
| First Name | CHANELLE |
| Middle Name | C |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
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| Organization Legal Name | WAL-MART STORES EAST LP |
| Group Practice Pac Id | 6204749997 |
| Number Of Group Practice Members | 29 |
| Line 1 Street Address | 2240 W DEKALB ST |
| Line 2 Street Address | |
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| City | CAMDEN |
| State | SC |
| Zip Code | 290202069 |
| Phone Number | 8039006028 |
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| Professional Accepts Medicare Assignment | M |
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