Individual
KIMBERLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
518 E MAIN ST, SPARTANBURG, SC 29302-1927
(864) 670-0373
Mailing address
518 E MAIN ST, SPARTANBURG, SC 29302-1927
(864) 670-0373
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
116725E
SC
Other
Enumeration date
10/01/2013
Last updated
12/08/2025
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