Individual
CHRISTANCIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 BLACK BEAR TRL, DOUGLASVILLE, GA 30135-5832
(404) 980-0313
Mailing address
5200 BLACK BEAR TRL, DOUGLASVILLE, GA 30135-5832
(404) 980-0313
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
CN0030057044
GA
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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