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Individual
JIHAD JACKSON
Active
Individual
JIHAD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-4901700
—
WI
05
—
823587205
—
WI
Enumeration date
06/05/2017
Last updated
06/07/2026
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