Queen Jackson

NPI 1558677013 - Community Health Worker - 172V00000X

NPI Details
NPI 1558677013
Gender Female
Enumeration Date 08/23/2010
Last Updated 08/23/2010
Entity Type Individual
Active Over 7 years ago
Practice Location
2100 COMER AVE
COLUMBUS GA, 31904-8725, US
Phone (706) 596-5583
Fax (706) 596-5589
Business Location
225 SMITH ST
CUTHBERT GA, 39840-6307, US
Phone (229) 732-6279
Fax
Toxanomy
Taxonomy Code 172V00000X
License State
License Number
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According to our database, Queen Jackson NPI is 1558677013, taxonomy code is 172V00000X Queen Jackson physically located at 2100 Comer Ave, Columbus GA, 31904-8725. NPI Number Queen Jackson has the Individual type.

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1558677013 NPI number is provided on an as is basis without warranty of any kind. 1558677013 is maintained by the National Plan & Provider Enumeration System. The contents of Queen Jackson are for informational purposes only.