Nathan Robert Jackson, IDC STUDENT is a student in an organized health care education training program in San Diego, CA. The provider is 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. Nathan Robert Jackson, IDC STUDENT NPI is 1134790728. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
SURFACE WARFARE MEDICAL INSTITUTE 34101 FARENHOLT AVE
SAN DIEGO, CA
ZIP 92134-001
Phone: (619) 532-7968
The enumeration date for this NPI number is 7/6/2021 and was last updated on 7/6/2021.