Individual
LAWANDA S. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3550 HIGHWAY, 468 WEST, FISCAL SERVICES, WHITFIELD, MS 39193-0157
(601) 351-8000
Mailing address
P.O. BOX 1 - FISCAL SERVICES, 3550 HIGHWAY, 468 WEST, WHITFIELD, MS 39193-0157
(601) 351-8000
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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