Jackson, Shavonta

Jackson, Shavonta is an sole proprietor health care provider with primary practice located at 1607 Barrington Vw , Stone Mountain GA 30087-1846. She recently has only one registered license in Nursing Service Related Providers / Nurse's Aide, which is considered as her primary health care specialty. Jackson, Shavonta can be contacted via phone (678) 582-9317.

Contact Information

Primary practice address
1607 Barrington Vw Stone Mountain GA 30087-1846
Phone: (678) 582-9317
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X CN0028901061 Georgia

Profile Details

NPI number 1336883602
LBN Legal business name Jackson, Shavonta
Credentials Certified in Nursing Administration (CNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2022
Last updated Apr 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336883602 NPPES
Georgia Other 9576376 CIGNA HEALTHCARE

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