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NPI Code Detail

MEDICARE: ANIYA JACKSON

MEDICARE: ANIYA JACKSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care AttendantNE

General Provider Information

NPI Number : 1184422271
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANIYA JACKSON
Provider Business Mailing Address
First Line : GENERAL DELIVERY
Second Line :
City : OMAHA
State : NE
Zip : 68108-9999
Country : US
Telephone Number : 402-555-1234
Fax Number :
Provider Business Practice Location Address
First Line : GENERAL DELIVERY
Second Line :
City : OMAHA
State : NE
Zip : 68108-9999
Country : US
Telephone Number : 402-555-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2025
Last Update Date : 03/04/2025

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Directions to “ ANIYA JACKSON ” Practice Location

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