Individual
STRACY JACKSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
901 S 3RD ST, MC GEHEE, AR 71654-2563
(870) 222-3805
(870) 222-3984
Mailing address
110 S ADAMS AVE, MC GEHEE, AR 71654-2105
(870) 222-3587
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
050024070304E
AR
Other
Enumeration date
12/19/2005
Last updated
07/08/2007
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