Individual
MRS. HOLLY MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29954 BAHNER QUARRY RD, TIPTON, MO 65081-3317
(573) 353-1292
Mailing address
29954 BAHNER QUARRY RD, TIPTON, MO 65081-3317
(573) 353-1292
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
06/30/2026
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