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Shawna Jackson
NPI 1225531411 · on the registry since 2018 · sole proprietor
Practice
- Address
- 100 Glendalough Ct Ste E
Tyrone, GA 30290 - Phone
- (770) 683-9375
- Clinicians at this address
- 10
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-03-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia