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Contact Information

TANDELA S BLOUNT JACKSON
120 ELLINGTON ST
PERRY, FL32348-5200
 Phone: 850-672-2628
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Homemaker

376J00000X
Indicates primary specialty

NPI Profile & details for TANDELA S BLOUNT JACKSON · (Female)

NPI # 1437920204
Status Active
Credentials
Entity Individual
Enumeration date 01/11/2024
Last updated 01/11/2024 - About 2 years ago
Sole proprietor 1 No
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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