person
Mr. Larry Randolph Jackson, REGISTEREDNURSE
Psychiatric/Mental Health Registered Nurse in Columbia, South Carolina
NPI 1093878191

Larry Randolph Jackson is a Psychiatric/Mental Health Registered Nurse based in Columbia, SC and is specialized in Psychiatric/Mental Health. Larry Randolph Jackson practices in Columbia, SC and has the professional credentials of REGISTEREDNURSE. The NPI Number for Larry Randolph Jackson is 1093878191 and holds a License No. 56879 (South Carolina).

The current practice location address for Larry Randolph Jackson is 615 Rapids Rd, Columbia, SC and can be reached out via phone at 803-798-2211. You can also correspond with Larry Randolph Jackson through the mailing address at 615 RAPIDS RD, COLUMBIA, SC - 29212-3024 (mailing address contact number: 803-798-2211).

Location: 615 Rapids Rd, Columbia, SC, 29212-3024
person
Provider Profile Details
NPI Number
1093878191
Provider Name
Larry Randolph Jackson
Credential
REGISTEREDNURSE
Provider Entity Type
Individual
Gender
Male
Address
615 Rapids Rd, Columbia, SC, 29212-3024
Phone Number
803-798-2211
Fax Number
Provider Enumeration Date
12/19/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
615 Rapids Rd
City
State
Zip
29212-3024
Phone Number
803-798-2211
Fax Number
person
Provider Business Mailing Address Details
Address
615 Rapids Rd
City
State
Zip
29212-3024
Phone Number
803-798-2211
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
56879 (South Carolina)
Definition
Definition to come...
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