Individual
MS. IEACHA SHAHARA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
66 CHURCH ST, RICHLAND, GA 31825-6210
(229) 449-1289
Mailing address
PO BOX 291, RICHLAND, GA 31825-0291
(229) 449-1289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07241421
GA
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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