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Individual

ANDREA JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19500 LOCHERIE AVE, EUCLID, OH 44119-1418
(216) 925-6484
Mailing address
19500 LOCHERIE AVE, EUCLID, OH 44119-1418
(216) 925-6484

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN187508
OH

Other

Enumeration date
04/24/2026
Last updated
04/24/2026
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