Individual
JACQUANNA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
942 HORSESHOE BEND RD, MONTEZUMA, GA 31063-6518
(229) 331-8885
Mailing address
942 HORSESHOE BEND RD, MONTEZUMA, GA 31063-6518
(229) 331-8885
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0028886420
GA
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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