National Provider Identifier Database

EBONY T JACKSON, CLTC, CHHA, CCNA – NPI #1588328637
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

EBONY T JACKSON, CLTC, CHHA, CCNA
5930 E 31ST ST STE 550
TULSA, OK74135-5121
Phone: 918-313-9591
Fax:
Website:
Specialty Taxonomy Code
* Specialist 174400000X
Gerontology 364SG0600X
Health & Wellness Coach 171400000X
In Home Supportive Care 253Z00000X
Long-Term Care 364SL0600X

* Indicates primary specialty

NPI Profile & details for EBONY T JACKSON

NPI Number 1588328637
Credentials CLTC, CHHA, CCNA
Entity Individual
Enumeration date 10/25/2021
Last updated 10/25/2021 - About 5 years ago
Sole proprietor1 Yes
Identifiers
  • OK License #: 37V954550119
  • OK License #: 37V954560119
Hospital affiliation n/a

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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