Individual
MRS. CHITAQUA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
25200 ROCKSIDE RD APT 423C, BEDFORD HTS, OH 44146-1915
(412) 225-6763
Mailing address
25200 ROCKSIDE RD APT 423C, BEDFORD HTS, OH 44146-1915
(412) 225-6763
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN155941
OH
Other
Enumeration date
10/07/2014
Last updated
10/09/2024
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