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Individual

CANDACE JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
174H00000X
Health Educator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
236
MS
01
568946544
BCBS
01
5874
HEALTH PROVIDER
Enumeration date
03/07/2023
Last updated
03/07/2023
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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