| Doctor Name: | LORA A JACKSON |
| NPI Number: | 1083760938 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 78444 |
| Business Practice Address: | 4185 E Wildcat Reserve Pkwy Ste 100 Highlands Ranch, CO - 801266801 |
| Business Phone Number: | 3037917896 |
| Business Fax Number: | 3037918152 |
| Mailing Address: | 4185 E Wildcat Reserve Pkwy, Ste 100 HIGHLANDS RANCH |
| State: | CO |
| Postal Code: | 801266801 |
| Phone Number: | 3037917896 |
| Fax Number: | 3037918152 |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 78444 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |