Individual
DEMETRIA A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
960 JOE FRANK HARRIS PKWY SE, CARTERSVILLE, GA 30120-2129
(478) 464-8134
Mailing address
2624 CHASE RDG, KENNESAW, GA 30144-0300
(404) 865-4215
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN-NP246390
GA
Other
Enumeration date
03/14/2025
Last updated
12/24/2025
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