MEDICARE: VERONICA 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	253Z00000X	In Home Supportive Care Agency	NV20253406032	NV

General Provider Information

NPI Number	:	1326994450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA JACKSON

Provider Business Mailing Address
First Line	:	4612 CATFISH BEND RD
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-4242
Country	:	US
Telephone Number	:	310-216-8074
Fax Number	:

Provider Business Practice Location Address
First Line	:	4612 CATFISH BEND RD
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-4242
Country	:	US
Telephone Number	:	310-216-8074
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ VERONICA JACKSON ” Practice Location

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