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NPI Code Detail

MEDICARE: LINDA JOYICE JACKSON

MEDICARE: LINDA JOYICE 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
1374U00000XHome Health Aide

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952910812
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA JOYICE JACKSON
Provider Business Mailing Address
First Line : 1516 E TROPICANA AVE STE 199
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-8323
Country : US
Telephone Number : 725-214-7776
Fax Number : 725-214-7768
Provider Business Practice Location Address
First Line : 1516 E TROPICANA AVE STE 199
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-8323
Country : US
Telephone Number : 725-214-7776
Fax Number : 725-214-7768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2020
Last Update Date : 07/27/2020

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Directions to “ LINDA JOYICE JACKSON ” Practice Location

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