Shana Lorene Cox Jackson, CPNP-PC
Nurse Practitioner, Pediatrics in Aiken, SC. Individual provider (NPI-1).
NPI number1730786641
StatusActive
Last updated in NPPESOct 29, 2021
Details
- NPI
- 1730786641
- Entity type
- Individual (NPI-1)
- Name
- Shana Lorene Cox Jackson
- Credential
- CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 4, 2020
- Certification date
- Oct 29, 2021
- Last updated
- Oct 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 25500 | SC | Yes |
| 163WP0200X | Registered Nurse, Pediatrics | 231529 | SC |
Practice location
206 Centre South BlvdAiken, SC 29803-6319
Phone 803-642-9204
Mailing address
206 Centre South BlvdAiken, SC 29803-6319
Phone 803-642-9204
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All 7 Pediatric Nurse Practitioner providers in Aiken · All 1,951 providers in Aiken
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