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Search › Missouri › 225200000X

Donica Jackson, CPTA

NPI 1881039683 · on the registry since 2013

Practice

Address
11900 Jessica Ln
Raytown, MO 64138
Phone
(816) 743-0085
Organisation at this address
Phem, Llc
Edgewood Snf Opco Llc
Genesis Rehab Services
Edgewood Manor Opco, Llc
Edgewood Manor Operations Management Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2013-05-07

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 Missouri