Luewana Kim Jackson
Contractor in Columbus, OH. Individual provider (NPI-1).
NPI number1174863922
StatusActive
Last updated in NPPESJul 31, 2014
Details
- NPI
- 1174863922
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Luewana Kim Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 14, 2013
- Last updated
- Jul 31, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | – | – | Yes |
Practice location
4466 Kimmel RdColumbus, OH 43224-1131
Phone 614-262-3559
Mailing address
4466 Kimmel RdColumbus, OH 43224-1131
Phone 614-262-3559
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