Tiffany Michelle Jackson LPN

NPI 1003158015 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1003158015
Gender Female
Enumeration Date 03/18/2013
Last Updated 03/18/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
100 BLASSINGAME RD
GREENVILLE SC, 29605-3304, US
Phone (864) 355-3100
Fax
Business Location
100 BLASSINGAME RD
GREENVILLE SC, 29605-3304, US
Phone (864) 355-3100
Fax
Toxanomy
Taxonomy Code 164W00000X
License State South Carolina
License Number P29859
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According to our database, Ms. Tiffany Michelle Jackson LPN NPI is 1003158015, taxonomy code is 164W00000X and license number is P29859, license state is located at South Carolina. Tiffany Michelle Jackson LPN physically located at 100 Blassingame Rd, Greenville SC, 29605-3304. NPI Number Tiffany Michelle Jackson LPN has the Individual type.

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1003158015 NPI number is provided on an as is basis without warranty of any kind. 1003158015 is maintained by the National Plan & Provider Enumeration System. The contents of Tiffany Michelle Jackson LPN are for informational purposes only.