Individual
MR. NATHANIEL JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2935 CHALKSTONE PL, WALDORF, MD 20601-4997
(240) 501-9552
Mailing address
3717 LUMAR DR, FT WASHINGTON, MD 20744-1861
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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