| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DEMETRIUS WILLIAM JACKSON | 1780341172 | 2021-11-21 |
Demetrius William Jackson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1780341172. Registration indicates Demetrius William Jackson is a provider of services with a specialization in Technician: Personal Care Attendant (Nursing Service Related Providers, Technician) (Technician Personal Care Attendant, Nursing Service Related Providers) (Technician, )
| Entity Type | Individual |
| Provider Name | Demetrius William Jackson |
| Practice Office Address | 3921 S ST SE WASHINGTON, DC US |
| Practice Office Telephone | 2024685522 |
| Mailing Address | 2320 24TH ST SE WASHINGTON, DC 200203402 US |
| Business Telephone | 2024914420 |
| Code | Practice | License No State |
|---|---|---|
| 3747P1801X PRIMARY | Technician: Personal Care Attendant Nursing Service Related Providers Technician Technician Personal Care Attendant Nursing Service Related Providers Technician |