ELIA DIANA JACKSON NPI 1568964955

NPI Information

Elia Diana Jackson is a student in an organized health care education training program in North Las Vegas, NV. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Elia Diana Jackson NPI is 1568964955. 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:

417 FOXVALE AVE
NORTH LAS VEGAS, NV
ZIP 89032-150
Phone: (702) 463-0082

The enumeration date for this NPI number is 3/2/2018 and was last updated on 3/2/2018.

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:

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