Stephfon Jackson
Driver in Milwaukee, WI. Individual provider (NPI-1).
NPI number1447921689
StatusActive
Last updated in NPPESSep 27, 2021
Details
- NPI
- 1447921689
- Entity type
- Individual (NPI-1)
- Name
- Stephfon Jackson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2021
- Certification date
- Sep 27, 2021
- Last updated
- Sep 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172A00000X | Driver | – | WI | Yes |
Practice location
2461 N 15th StMilwaukee, WI 53206-2008
Phone 414-812-1457
Mailing address
2461 N 15th StMilwaukee, WI 53206-2008
Phone 414-812-1457
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 172 Driver providers in Milwaukee · All 23,880 providers in Milwaukee
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