Individual
SHATONE E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024194324
VA
367500000X
Certified Registered Nurse Anesthetist
1-087755
AL
Other
Enumeration date
02/17/2012
Last updated
08/25/2025
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