Miranda Jackson
Individual provider Active NPI Attendant Care Provider · Sylvania, GA
NPI 1043933641 · NPPES record last updated Sep 20, 2022
Key facts
- NPI
- 1043933641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 6474 Savannah Hwy
Sylvania, GA 30467-9315 - Phone
- (912) 425-2479
- NPI assigned
- Sep 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
6474 Savannah Hwy
Sylvania, GA 30467-9315
Mailing address
6474 Savannah Hwy
Sylvania, GA 30467-9315
Phone (912) 425-2479
Other providers in Sylvania, GA
- Christopher Lee Griner
- C. Edward Hagan
- Healthstat on-Site Clinic-Milliken Longleaf
- Margaret Ann Hollingsworth
- Valarie Hopkins
- Sharon A. Jacobs
- Mary Lana Jarrell
- Jenkins County Hospital LLC
- Jenkins County Hospital, LLC
- Latrell Jenkins
All providers in Sylvania, GA · Attendant Care Provider in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.