Jacquelyn Marie Jackson
Nurse's Aide in Mt Pleasant, SC. Individual provider (NPI-1).
NPI number1366627002
StatusActive
Last updated in NPPESDec 31, 2007
Details
- NPI
- 1366627002
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jacquelyn Marie Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 31, 2007
- Last updated
- Dec 31, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 376K00000X | Nurse's Aide | 120514E | – | Yes |
| 374U00000X | Home Health Aide | 120514E | – | |
| 376J00000X | Homemaker | – | – |
Practice location
1609 Hiway 41Mt Pleasant, SC 29464
Phone 843-870-1839
Mailing address
Po Box 2522Mt Pleasant, SC 29464
Phone 843-870-1839
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