| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ANTHONIE D JACKSON | 1083438709 | 2024-11-09 |
Anthonie D Jackson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1083438709. Registration indicates Anthonie D Jackson is a provider of services with a specialization in Nursing Service Related Providers, Homemaker (Homemaker, ) (Homemaker, Nursing Service Related Providers)
| Entity Type | Individual |
| Provider Name | Anthonie D Jackson |
| Practice Office Address | 1470 E 173RD ST CLEVELAND, OH US |
| Practice Office Telephone | 2164661379 |
| Mailing Address | 1470 E 173RD ST CLEVELAND, OH 441102931 US |
| Business Telephone | 2164661379 |
| Code | Practice | License No State |
|---|---|---|
| 376J00000X PRIMARY | Nursing Service Related Providers Homemaker Homemaker Homemaker Nursing Service Related Providers |