Individual
MRS. CYNTHIA LEE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
170 MICHAEL AVE, HAMILTON, OH 45011-4731
(513) 460-9828
Mailing address
170 MICHAEL AVE, HAMILTON, OH 45011-4731
(513) 460-9828
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN129775
OH
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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