Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACY JACKSON
Active Sole ProprietorSTACY JACKSON is a Bus healthcare provider located in INDIANOLA, Mississippi. NPI 1922533827 is currently active in the NPPES registry. Verify at CMS.
Bus · INDIANOLA, MS
Registration Details
- NPI Number
- 1922533827
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 28, 2017 (9.2704382167935 yrs)
- Last Updated
- Apr 28, 2017
- Sole Proprietor
- Yes
Practice Information
- Address
-
201 WIGGINS RD APT 13INDIANOLA, MS, 387513478Browse MS providers · Browse ZIP 38751
- Phone
- 6623036959
- Primary Specialty
-
Bus
343900000X
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.