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Individual
KAYLA LYNN JACKSON
Active
Individual
KAYLA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
0112400
OH
376J00000X
Homemaker
Primary
0112400
OH
376K00000X
Nurse's Aide
401084350510
OH
385H00000X
Respite Care
0112400
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112400
—
OH
01
—
401084350510
STATE TESTED NURSE AIDE
OH
Enumeration date
01/12/2015
Last updated
01/12/2015
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