Individual
KIERRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2611 SIERRA DRIVE APT. F, BELLEVILLE, IL 62221
(618) 593-7833
Mailing address
2611 SIERRA DR APT F, BELLEVILLE, IL 62221-8908
(618) 593-7833
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
07/21/2022
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