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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LATANYA JACKSON, PBT

Active Sole Proprietor

Technician, Pathology · CLARKSVILLE, TN

Registration Details

NPI Number
1558072421
Provider Type
Individual
Gender
Female
NPI Issued
Dec 12, 2022 (3.360213698636 yrs)
Last Updated
Dec 12, 2022
License
67093 (TN)
Sole Proprietor
Yes

Practice Information

Address
315 PROVIDENCE BLVD
CLARKSVILLE, TN, 370424325
Browse TN providers · Browse ZIP 37042
Phone
6153003724
Primary Specialty
Technician, Pathology
246R00000X
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.