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1336883602
SHAVONTA JACKSON
STONE MOUNTAIN, GA
NPI
1336883602
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
376K00000X Nurse's Aide
(Licence: GA CN0028901061)
Enumeration Date
2022-04-23
Last Update Date
2022-04-23
Business Address
SHAVONTA JACKSON CNA
1607 BARRINGTON VW
STONE MOUNTAIN, GA 30087-1846
Phone number: 678-582-9317
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Mailing Address
SHAVONTA JACKSON CNA
1607 BARRINGTON VW
STONE MOUNTAIN, GA 30087-1846
Phone number: 678-582-9317
Copy
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