NPI 1679143747

Stephanie S Jackson

Practitioner Contractor Sylvester, GA

Practice location

Address: 262 Pebble Hill Cir, Sylvester, GA 31791-7759
Phone: (229) 206-2767

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1679143747
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jun 2021
Record last updated: 30 Jun 2021

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.