Individual
MALIZA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3192 DIXIE HWY, ERLANGER, KY 41018-1850
(859) 609-1011
Mailing address
96 GEIGER AVE, BELLEVUE, KY 41073-1622
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
1136570
KY
163WC0400X
Case Management Registered Nurse
Primary
1136570
KY
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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