Individual
MRS. NISSA NICOLE JACOBSON GERLOSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6355 NEWSTONE DR, #103, BARTLETT, TN 38135-9231
(901) 383-4462
Mailing address
6355 NEWSTONE DR, #103, BARTLETT, TN 38135-9231
(901) 383-4462
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2762818
—
OH
Enumeration date
01/08/2009
Last updated
01/08/2009
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