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Tangenee Jackson
NPI 1750131710 · on the registry since 2024 · sole proprietor
Practice
- Address
- 5148 Callan Dr
Indianapolis, IN 46254 - Phone
- (317) 373-1921
- Fax
- (317) 875-1408
Registry record
- Primary taxonomy
- 253Z00000X
253Z00000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-12-12
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 Indiana