Individual
JESSICA LEEANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2643 PORTSMOUTH PL, HEPHZIBAH, GA 30815-6434
(309) 230-0903
Mailing address
2643 PORTSMOUTH PL, HEPHZIBAH, GA 30815-6434
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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