Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LATORIA NICOLE JACKSON
Active Sole ProprietorLATORIA NICOLE JACKSON is a Bus healthcare provider located in LOGANVILLE, Georgia. NPI 1922500289 is currently active in the NPPES registry. Verify at CMS.
Bus · LOGANVILLE, GA
Registration Details
- NPI Number
- 1922500289
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 2, 2018 (8.4382705733807 yrs)
- Last Updated
- Mar 2, 2018
- Sole Proprietor
- Yes
Practice Information
- Address
-
4150 ALEXIS CTLOGANVILLE, GA, 300529070Browse GA providers · Browse ZIP 30052
- Phone
- 6786710078
- Fax
- 8889482083
- Primary Specialty
-
Bus
343900000X
- Additional Specialty
- Case Management Agency
- Additional Specialty
- Behavioral Health, Residential
- Additional Specialty
- Community/Behavioral Health
- Additional Specialty
- Adult Day Care Facility
Other Bus Providers in LOGANVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| EMMANUEL ADEOGUN | — | 1184213563 |
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.