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

ROGER JACKSON

Active Sole Proprietor

ROGER JACKSON is a Home Health Nurse healthcare provider located in LA FOLLETTE, Tennessee. NPI 1720653629 is currently active in the NPPES registry. Verify at CMS.

Home Health Nurse · LA FOLLETTE, TN

Registration Details

NPI Number
1720653629
Provider Type
Individual
Gender
Male
NPI Issued
May 24, 2021 (5.2520276216559 yrs)
Last Updated
May 24, 2021
Licenses
102279 (TN)
102279 (TN)
102279 (TN)
102279 (TN)
102279 (TN)
Sole Proprietor
Yes

Practice Information

Address
171 NOAH LN
LA FOLLETTE, TN, 377665575
Browse TN providers · Browse ZIP 37766
Phone
4239125097
Primary Specialty
Home Health Nurse
163WH0200X
Additional Specialty
Community Health Nurse
Additional Specialty
Hospice Nurse
Additional Specialty
Medical-Surgical Nurse
Additional Specialty
Nutrition Support Nurse
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.