Individual
MRS. PATRICE M JACKSON-WEATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
—
—
376K00000X
Nurse's Aide
344541
WI
376K00000X
Nurse's Aide
560249
SC
376K00000X
Nurse's Aide
Primary
CN0014212008
GA
Other
Enumeration date
06/08/2015
Last updated
02/10/2024
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