Individual
CHENELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1062 LINN ST, CINCINNATI, OH 45203-1323
(513) 720-9481
Mailing address
1062 LINN ST, CINCINNATI, OH 45203-1323
(513) 720-9481
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN154488-M-IV
OH
Other
Enumeration date
07/20/2014
Last updated
01/28/2015
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