Individual
MR. DESEAN MICHAEL JACKSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMJ
Contact information
Practice address
510 E 2ND ST, TRENTON, NE 69044-1817
(308) 340-3106
Mailing address
305 CIRCLE DR, TRENTON, NE 69044-1824
(316) 925-1895
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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