Dmeka Jackson
Home Health Aide in Rockford, IL. Individual provider (NPI-1).
NPI number1063230159
StatusActive
Last updated in NPPESSep 28, 2024
Details
- NPI
- 1063230159
- Entity type
- Individual (NPI-1)
- Name
- Dmeka Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2024
- Certification date
- Sep 28, 2024
- Last updated
- Sep 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | $$$$$$$$$ | IL | Yes |
Practice location
1410 Ridge AveRockford, IL 61103-6033
Phone 779-423-7866
Mailing address
1410 Ridge AveRockford, IL 61103-6033
Phone 779-423-7866
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