Individual
SHANICE B JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 S 50TH ST, OMAHA, NE 68117-1355
(402) 718-6700
Mailing address
7935 N 154TH AVE, BENNINGTON, NE 68007-1819
(402) 250-9338
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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