Individual
ERICA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5671 PRESTONWOOD CT, INDIANAPOLIS, IN 46254-5022
(317) 603-9497
Mailing address
5671 PRESTONWOOD CT, INDIANAPOLIS, IN 46254-5022
(317) 603-9497
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
24-018154-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300108731
—
IN
Enumeration date
04/30/2025
Last updated
04/30/2025
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