NPI 1063230159

Dmeka Jackson

Practitioner Home Health Aide Rockford, IL

Practice location

Address: 1410 Ridge Ave, Rockford, IL 61103-6033
Phone: (779) 423-7866

Registered specialties

Home Health Aide Primary

Nursing Service Related Providers Taxonomy 374U00000X Licence $$$$$$$$$ (IL)

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Registry record

NPI: 1063230159
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Sep 2024
Record last updated: 28 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.