| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KATHRYN M JACKSON | 1073119525 | 2024-01-02 |
Kathryn M Jackson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1073119525. Registration indicates Kathryn M Jackson is a provider of services with a specialization in Nursing Service Related Providers, Home Health Aide (Home Health Aide, ) (Home Health Aide, Nursing Service Related Providers)
| Entity Type | Individual |
| Provider Name | Kathryn M Jackson |
| Practice Office Address | 2020 BROWNLEE AVE YOUNGSTOWN, OH US |
| Practice Office Telephone | 3040296413 |
| Mailing Address | 2020 BROWNLEE AVE YOUNGSTOWN, OH 445141016 US |
| Business Telephone | 3302078602 |
| me [] | me | Direct |
| Code | Practice | License No State |
|---|---|---|
| 374U00000X PRIMARY | Nursing Service Related Providers Home Health Aide Home Health Aide Home Health Aide Nursing Service Related Providers |
| 1235809237 | MEDICAID | OH | |
| 1073119525 | OTHER | OH | NPI |