Individual provider · NPI-1

Damita Jackson, CNA

Nurse's Aide · Kansas City, MO

NPI number1982366845
StatusActive
Last updated in NPPESOct 7, 2021

Details

NPI
1982366845
Entity type
Individual (NPI-1)
Name
Damita Jackson
Credential
CNA
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 7, 2021
Certification date
Oct 7, 2021
Last updated
Oct 7, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
376K00000X Nurse's Aide100018AMOYes
246ZS0410X Specialist/Technologist, Other, Surgical Technologist189164VA

Practice location

1616 Ne 81st St
Kansas City, MO 64118-8245

Phone 816-783-7938

Mailing address

1616 Ne 81st St
Kansas City, MO 64118-8245

Phone 816-783-7938

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