Individual
TYNA CARSHELLA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
10106 STRONECREST TRL, STONECREST, GA 30038
(706) 877-4979
Mailing address
10106 STRONECREST TRL, STONECREST, GA 30038
(706) 877-4979
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN300323
GA
163WM0705X
Medical-Surgical Registered Nurse
RN300323
GA
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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