Keilon Latrice Jackson in Lawrenceville - Nurse's Aide
Keilon Latrice Jackson - NPI 1285852764
Keilon Latrice Jackson is a Nurse's Aide in Lawrenceville, Georgia. Keilon Latrice Jackson practices all healthcare services and medical treatments related to Nurse's Aide. The NPI Number for Keilon Latrice Jackson is 1285852764. The last update date is 2012-01-05.
Keilon Latrice Jackson's current location address is 511 Downing St, Lawrenceville, Georgia. You can contact this provider via phone number 6785779097. The mailing address for Keilon Latrice Jackson is 511 Downing St, Lawrenceville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keilon Latrice Jackson |
|---|---|
| Address | 511 Downing St, Lawrenceville, Georgia |
| Phone Number | 6785779097 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | CMA |
NPI Number Detail
| NPI Number | 1285852764 |
|---|---|
| Provider Enumeration Date | 2007-04-23 |
| Last Updated Date | 2012-01-05 |
Provider Mailing Address Detail
| Address | 511 Downing St |
|---|---|
| City | Lawrenceville |
| State | Georgia (GA) |
| Post Code | 300454597 |
| Phone Number | 6785779097 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Nurse's Aide |
|---|---|
| Taxonomy | 376K00000X |
| Licence No | 20019336068 |
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Definition: (1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course genera |
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What is the unique identification code assigned to Keilon Latrice Jackson by the Centers for Medicare & Medicaid Services?
The Keilon Latrice Jackson has been issued the NPI (National Provider Identifier) 1285852764. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Keilon Latrice Jackson is physically located?
The Keilon Latrice Jackson is physically situated at the following address: 511 Downing St, Lawrenceville, GA, 300454597.
What is the Keilon Latrice Jackson's specialty and taxonomy code?
The Keilon Latrice Jackson's specialty is Nurse's Aide, and the corresponding taxonomy code is 376K00000X.
On what date did the Keilon Latrice Jackson receive the assignment of its 1285852764 from the Centers for Medicare & Medicaid Services?
The Keilon Latrice Jackson was issued its 1285852764 by the Centers for Medicare & Medicaid Services on 2007-04-23.
As of what date were the details related to Keilon Latrice Jackson most recently updated or revised?
The information pertaining to Keilon Latrice Jackson, including its address, specialty, and other relevant details, was last updated or revised on 2012-01-05.