Individual
KHIANA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1543 CLOVERNOLL DR, CINCINNATI, OH 45231-5403
(513) 300-0688
Mailing address
1543 CLOVERNOLL DR, CINCINNATI, OH 45231-5403
(513) 300-0688
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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