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Cooper Marc Jackson
Student in an Organized Health Care Education/Training Program in Lakeville, Minnesota
NPI 1053013383

Cooper Marc Jackson is a Student in an Organized Health Care Education/Training Program based in Lakeville, MN. Cooper Marc Jackson practices in Lakeville, MN. The NPI Number for Cooper Marc Jackson is 1053013383 and holds a License No. (Minnesota).

The current practice location address for Cooper Marc Jackson is 21262 Inspiration Path, Lakeville, MN and can be reached out via phone at 612-616-6866.

Location: 21262 Inspiration Path, Lakeville, MN, 55044-6028
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053013383
Provider Name
Cooper Marc Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
21262 Inspiration Path, Lakeville, MN, 55044-6028
Phone Number
612-616-6866
Fax Number
Provider Enumeration Date
03/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
21262 Inspiration Path
City
Lakeville
State
Minnesota
Zip
55044-6028
Phone Number
612-616-6866
Fax Number
person
Provider Business Mailing Address Details
Address
21262 Inspiration Path
City
Lakeville
State
Minnesota
Zip
55044-6028
Phone Number
612-616-6866
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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