Individual
JENNIFER JO JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 377-5525
Mailing address
814 TIPTON AVE, DYERSBURG, TN 38024-3328
(731) 377-5525
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00115287
TN
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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