IndividualActive
Lauran Jackson
NPI 1063357473 · Medical Toxicology (Preventive Medicine) Physician · Petersburg, VA
Provider details
- NPI number
- 1063357473
- Entity type
- Individual
- Primary specialty
- Medical Toxicology (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 1401115318 (VA)
Mailing address
10543 South Crater Road
Petersburg, VA 23805
Registry dates
- Enumerated
- 2026-04-22
- Last updated
- 2026-04-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.