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1508561796
KIMBERLY L JACKSON
ELIZABETHTOWN, KY
NPI
1508561796
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-04-05
Last Update Date
2023-04-05
Business Address
KIMBERLY L JACKSON
415 E DIXIE AVE
ELIZABETHTOWN, KY 42701-1162
Phone number: 270-982-7378
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Mailing Address
KIMBERLY L JACKSON
PO BOX 6098
ELIZABETHTOWN, KY 42702-6098
Phone number: 270-982-7372
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