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1841699170
LASHANA JACKSON
CORAM, NY
NPI
1841699170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 295625)
Enumeration Date
2014-08-22
Last Update Date
2014-08-22
Business Address
-- LASHANA JACKSON
29 COUNTRY CLUB DR APT B
CORAM, NY 11727-3420
Phone number: 631-786-6874
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Mailing Address
-- LASHANA JACKSON
29 COUNTRY CLUB DR APT B
CORAM, NY 11727-3420
Phone number:
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