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Contact Information

BIANCA J JACKSON
2508 SHANNON CT
HEPHZIBAH, GA30815-6633
 Phone: 706-284-1533
 Fax: 706-284-1533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
 

Residential Treatment Facility, Physical Disabilities

320700000X
Indicates primary specialty

NPI Profile & details for BIANCA J JACKSON · (Female)

NPI Number 1992387823
Status Active
Credentials
Entity Individual
Enumeration date 04/21/2021
Last updated 04/10/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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