Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LAVERNE JACKSON
Active Sole ProprietorLAVERNE JACKSON is a Primary Care Clinic healthcare provider located in QUITMAN, Georgia. NPI 1134593353 is currently active in the NPPES registry. Verify at CMS.
Primary Care Clinic · QUITMAN, GA
Registration Details
- NPI Number
- 1134593353
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 27, 2015 (10.734355399769 yrs)
- Last Updated
- Nov 27, 2015
- License
-
RN130090 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
903 N COURT STQUITMAN, GA, 316431315Browse GA providers · Browse ZIP 31643
- Phone
- 2292637147
- Fax
- 2292636318
- Primary Specialty
-
Primary Care Clinic
261QP2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.