Individual
JAID MONIQUE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
902 SUMMIT GARDENS BLVD, KENT, OH 44240-7736
(216) 867-8668
Mailing address
902 SUMMIT GARDENS BLVD, KENT, OH 44240-7736
(216) 867-8668
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
161993
OH
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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