MISS KEILON LATRICE JACKSON CMA NPI 1285852764

NPI Information

NPI: 1285852764
Provider Name: MISS KEILON LATRICE JACKSON, CMA
Classification: Home Health Aide - 374U00000X
Entity Type: Individual
Address:
511 DOWNING ST
LAWRENCEVILLE, GA
ZIP 30045
Phone: (678) 577-9097
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MISS Keilon Latrice Jackson, CMA is a home health aide in Lawrenceville, GA. The provider is a person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. MISS Keilon Latrice Jackson, CMA NPI is 1285852764. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

511 DOWNING ST
LAWRENCEVILLE, GA
ZIP 30045-597
Phone: (678) 577-9097

The enumeration date for this NPI number is 4/23/2007 and was last updated on 1/5/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	372600000X	Adult Companion	20019336068	GEORGIA	No
2	376K00000X	Nurse's Aide	20019336068	GEORGIA	No
3	374U00000X	Home Health Aide	20019336068	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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