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1952859605
SHANTIEA M JACKSON
CANTON, OH
NPI
1952859605
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OH LPN.128068.MEDS-IV)
Enumeration Date
2016-09-12
Last Update Date
2016-09-12
Business Address
-- SHANTIEA M JACKSON LPN
625 CLEVELAND AVE NW
CANTON, OH 44702-1805
Phone number: 330-453-8252
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Mailing Address
-- SHANTIEA M JACKSON LPN
625 CLEVELAND AVE NW
CANTON, OH 44702-1805
Phone number: 330-453-8252
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