Individual
KENDRA D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6210 LITCHFORD FOREST LN APT 308, RALEIGH, NC 27615-7173
(252) 316-2170
Mailing address
PO BOX 28544, RALEIGH, NC 27611-8544
(252) 316-2170
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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