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General NPI Number Information
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NPI Number | 1750122933
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Entity Type | Individual
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Provider Name | SHERRI LEE JACKSON
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 4893 RIVERCREST DR
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City | HARRISON
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State | OH
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Zip | 45030-8564
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Country | US
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Telephone | 513-364-6685
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 LINK SIDE DR APT 6
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City | CINCINNATI
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State | OH
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Zip | 45245-2962
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Country | US
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Telephone | 513-375-7970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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