Search › Georgia › 174H00000X
Keriana Jackson
NPI 1790529329 · on the registry since 2024 · sole proprietor
Practice
- Address
- 1331 Rose Terrace Cir
Loganville, GA 30052 - Phone
- (678) 622-6687
Registry record
- Primary taxonomy
- 174H00000X
174H00000X
- Also registered as
- 332B00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-06-19
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