Ebony Jackson
Pharmacy Technician in Brunswick, GA. Individual provider (NPI-1).
NPI number1164073334
StatusActive
Last updated in NPPESSep 27, 2019
Details
- NPI
- 1164073334
- Entity type
- Individual (NPI-1)
- Name
- Ebony Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2019
- Last updated
- Sep 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183700000X | Pharmacy Technician | PHTC018695 | GA | Yes |
Practice location
145 Emanuel Farm Rd Lot 77Brunswick, GA 31525-2469
Phone 912-571-2850
Mailing address
145 Emanuel Farm Rd Lot 77Brunswick, GA 31525-2469
Phone 912-571-2850
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