Individual
KEISHA PERRY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
988 USS JAMES MADISON RD, BUILDING 1028, KINGS BAY, GA 31547
(912) 573-6578
(912) 573-2597
Mailing address
302 EAGLE VIEW DR, SENATOBIA, MS 38668-1206
(662) 629-2209
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
906900
MS
Other
Enumeration date
08/24/2024
Last updated
01/08/2026
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