Jacquenett Jackson

NPI 1376727388 - Custodial Care Facility - 311ZA0620X

NPI Details
NPI 1376727388
Gender Female
Enumeration Date 12/27/2007
Last Updated 12/27/2007
Entity Type Individual
Active Over 8 years ago
Practice Location
114 SECOND STREET
SHUBUTA MS, 39360, US
Phone (601) 687-1128
Fax (601) 687-5497
Business Location
PO BOX 462
SHUBUTA MS, 39360-0462, US
Phone (601) 687-1128
Fax (601) 687-5497
Toxanomy
Taxonomy Code 311ZA0620X
License State
License Number
Remove 1376727388 NPI Number
 

According to our database, Mrs. Jacquenett Jackson NPI is 1376727388, taxonomy code is 311ZA0620X Jacquenett Jackson physically located at 114 Second Street, Shubuta MS, 39360. NPI Number Jacquenett Jackson has the Individual type.

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1376727388 NPI number is provided on an as is basis without warranty of any kind. 1376727388 is maintained by the National Plan & Provider Enumeration System. The contents of Jacquenett Jackson are for informational purposes only.