Desean Michael Jackson I, DMJ
Technician, Personal Care Attendant in Trenton, NE. Individual provider (NPI-1).
NPI number1114724176
StatusActive
Last updated in NPPESFeb 27, 2025
Details
- NPI
- 1114724176
- Entity type
- Individual (NPI-1)
- Name
- Mr. Desean Michael Jackson I
- Credential
- DMJ
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 27, 2025
- Certification date
- Feb 27, 2025
- Last updated
- Feb 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
| 372500000X | Chore Provider | – | – | |
| 372600000X | Adult Companion | – | – |
Practice location
510 E 2nd StTrenton, NE 69044-1817
Phone 308-340-3106
Mailing address
305 Circle DrTrenton, NE 69044-1824
Phone 316-925-1895
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