SearchGeorgia253Z00000X

Bianca Jackson

NPI 1992387823 · on the registry since 2021 · sole proprietor

Practice

Address
2508 Shannon Ct
Hephzibah, GA 30815
Phone
(706) 284-1533
Fax
(706) 284-1533

Registry record

Primary taxonomy
253Z00000X
253Z00000X
Also registered as
253Z00000X
320700000X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-04-10

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