Individual
DIANE KAY JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9336 TOWNSHIP HIGHWAY 121, UPPER SANDUSKY, OH 43351-9797
(740) 360-0954
Mailing address
9336 TOWNSHIP HIGHWAY 121, UPPER SANDUSKY, OH 43351-9797
(740) 360-0954
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN088124
OH
Other
Enumeration date
08/28/2009
Last updated
08/28/2009
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