Individual provider · Type 1 NPI

Kathy L. Jackson

Private Vehicle · Marshall, IL

NPI number 1619283595 Active

Practice location

15685 N Iron Bridge Rd
Marshall, IL 62441-4663

Call (812) 241-6704 Map

Specialties and licenses

TaxonomyCodeLicense
Private Vehicle Primary 347C00000XJ250-5125-9895 (IL)

Private Vehicle: An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.

About NPI 1619283595

Kathy L. Jackson's National Provider Identifier is 1619283595, issued on Aug 30, 2010. The primary taxonomy on file is Private Vehicle (347C00000X), and the practice location is in Marshall, IL. The record was last updated on Aug 30, 2010.