person
Dr. Kimberley Evelyn Jackson, DO
General Practice Physician in Pueblo, Colorado
NPI 1154586832

Kimberley Evelyn Jackson is a General Practice Physician based in Pueblo, CO. Kimberley Evelyn Jackson practices in Pueblo, CO and has the professional credentials of DO. The NPI Number for Kimberley Evelyn Jackson is 1154586832 and holds a License No. OS014960 (Colorado).

The current practice location address for Kimberley Evelyn Jackson is 902 Lakeview Ave, Pueblo, CO and can be reached out via phone at 719-557-5855 and via fax at 719-557-4690.

Location: 902 Lakeview Ave, Pueblo, CO, 81004-3597
person
Provider Profile Details
NPI Number
1154586832
Provider Name
Kimberley Evelyn Jackson
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
902 Lakeview Ave, Pueblo, CO, 81004-3597
Phone Number
719-557-5855
Fax Number
719-557-4690
Provider Enumeration Date
07/22/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
OS014960 01 PA PENNSYLVANIA OSTEOPATHIC MEDICAL BOARD
50533 01 CO COLORADO LICENSE
institution
Provider Business Practice Location Address Details
Address
902 Lakeview Ave
City
State
Zip
81004-3597
Phone Number
719-557-5855
Fax Number
719-557-4690
person
Provider Business Mailing Address Details
Address
902 Lakeview Ave
City
State
Zip
81004-3597
Phone Number
719-557-5855
Fax Number
719-557-4690
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
OS014960 (Pennsylvania)
Definition
Definition to come...
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