Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEROME ALEXANDER-TERRELL JACKSON
Active Sole ProprietorJEROME ALEXANDER-TERRELL JACKSON is a Foster Care Agency healthcare provider located in PEORIA, Arizona. NPI 1740815497 is currently active in the NPPES registry. Verify at CMS.
Foster Care Agency · PEORIA, AZ
Registration Details
- NPI Number
- 1740815497
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 3, 2020 (6.4747588278861 yrs)
- Last Updated
- Mar 3, 2020
- Licenses
-
10195508 (AZ)10195508 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
9680 W NORTHERN AVE UNIT 2311PEORIA, AZ, 853454655Browse AZ providers · Browse ZIP 85345
- Phone
- 9899808286
- Fax
- 6024554626
- Primary Specialty
-
Foster Care Agency
253J00000X
- Additional Specialty
- Foster Care Agency
Other Foster Care Agency Providers in PEORIA, AZ
| Name | Credential | NPI |
|---|---|---|
| CHRISTINA HIRMIZ | — | 1578009742 |
| SANDRA ESCARCEGA | — | 1013528447 |
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.