Individual
KAYDREYANNA JACKSON
Active
Individual
KAYDREYANNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
1201132983
VA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
VA
Other
Enumeration date
07/21/2025
Last updated
06/19/2026
Update your record
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