Search › Virginia › 172V00000X
Jatai Jackson
NPI 1962909259 · on the registry since 2018
Practice
- Address
- 15022 Sunny Ridge Ct
Woodbridge, VA 22191 - Phone
- (202) 439-3667
- Organisation at this address
- Providers Inc Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 172V00000X
172V00000X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-12-02
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 Virginia