| Doctor Name: | RUTH ANNE JACKSON |
| NPI Number: | 1215948757 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN-C |
| License Number: | R033792 |
| Business Practice Address: | 736 Old Lewiston Rd Winthrop, ME - 043644121 |
| Business Phone Number: | 2073778122 |
| Business Fax Number: | 2073778564 |
| Mailing Address: | 736 Old Lewiston Rd, WINTHROP |
| State: | ME |
| Postal Code: | 043644121 |
| Phone Number: | 2073778122 |
| Fax Number: | 2073778564 |
| NPI Enumeration Date: | 08/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | R033792 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |