Individual
MEGAN KAYLA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 TRAVELERS BLVD, SUMMERVILLE, SC 29485-8213
(864) 593-9996
Mailing address
3800 S OCEAN DR STE 209, HOLLYWOOD, FL 33019-2915
(800) 226-8874
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2172986
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
25303
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
8441
MN
Other
Enumeration date
07/09/2020
Last updated
07/20/2026
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