MEDICARE: KIERRA LASHAY 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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1083282420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIERRA LASHAY JACKSON

Provider Business Mailing Address
First Line	:	1712 E GROVE ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-3339
Country	:	US
Telephone Number	:	773-503-7137
Fax Number	:

Provider Business Practice Location Address
First Line	:	1712 E GROVE ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-3339
Country	:	US
Telephone Number	:	773-503-7137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2021
Last Update Date	:	06/13/2021

Similar Medicare Providers

1528064169 — DR. LISA TONI DAVIS KULP D.M.D.
Practice Location Address:

4517 N 32ND ST
PHOENIX, AZ
85018-3339

Practice Phone: 480-924-3062
Practice Fax:

1003858671 — SMITHS FOOD & DRUG CENTERS INC
Practice Location Address:

6601 W INDIAN SCHOOL RD
PHOENIX, AZ
85033-3339

Practice Phone: 623-846-1533
Practice Fax: 623-846-6403

1922178086 — VALLEY DENTAL GROUP, LTD
Practice Location Address:

4517 N 32ND ST
PHOENIX, AZ
85018-3339

Practice Phone: 602-956-2260
Practice Fax: 602-956-0479

1568532570 — MY FAMILY DENTIST PC
Practice Location Address:

4517 N 32ND ST
PHOENIX, AZ
85018-3339

Practice Phone: 602-956-2280
Practice Fax: 602-956-0479

1265616643 — ARTISAN PROSTHETICS LLC
Practice Location Address:

4501 N 32ND ST
PHOENIX, AZ
85018-3339

Practice Phone: 602-667-7827
Practice Fax: 602-667-7826

1841456951 — TAMMY LYNN REDL HIS
Practice Location Address:

3509 E SHEA BLVD STE 117
PHOENIX, AZ
85028-3339

Practice Phone: 720-385-3700
Practice Fax: 602-996-3060

Directions to “ KIERRA LASHAY JACKSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.