Individual
MS. DENITA LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
30 HEFFRON DR, APT G, FAIRFIELD, OH 45014-7165
(513) 846-8355
Mailing address
30 HEFFRON DR, APT G, FAIRFIELD, OH 45014-7165
(513) 846-8355
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-109412
OH
Other
Enumeration date
07/08/2010
Last updated
12/06/2013
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