Individual provider · Type 1 NPI

Blake Jackson

Student in an Organized Health Care Education/Training Program · Jonesboro, AR

NPI number 1891480273 Active

Practice location

300 Carson St
Jonesboro, AR 72401-3104

Call (709) 321-1988 Map

Fax (870) 910-7700

Mailing address

4 Willow Creek Ln Apt 4302
Jonesboro, AR 72404-7991

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1891480273

Blake Jackson's National Provider Identifier is 1891480273, issued on Apr 10, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jonesboro, AR. The record was last updated on Apr 10, 2023.