NPI 1629704499

Shantay Jackson

Practitioner Homemaker Davenport, FL

Practice location

Address: 1954 Marabou Dr, Davenport, FL 33896-8616
Phone: (407) 995-9094

Registered specialties

Homemaker Primary

Nursing Service Related Providers Taxonomy 376J00000X Licence 422805 (FL)

Other Homemaker providers in Florida →

Registry record

NPI: 1629704499
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jul 2022
Record last updated: 25 Jul 2022

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.