NPI 1376727388
Jacquenett Jackson
Practice location
- Address
- 114 Second Street, Shubuta, MS 39360
- Phone
- (601) 687-1128
- Fax
- (601) 687-5497
- Mailing address
- PO Box 462, Shubuta, MS 39360-0462
Registered specialties
Adult Care Home Facility
Primary
Registry record
- NPI
- 1376727388
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 27 Dec 2007
- Record last updated
- 27 Dec 2007
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.