Desean Michael Jackson I, DMJ
Individual provider Active NPI Personal Care Attendant · Trenton, NE
NPI 1114724176 · NPPES record last updated Feb 27, 2025
Key facts
- NPI
- 1114724176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 510 E 2ND St
Trenton, NE 69044-1817 - Phone
- (308) 340-3106
- NPI assigned
- Feb 27, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chore Provider | 372500000X | |||
| Adult Companion | 372600000X | |||
| Personal Care Attendant |
3747P1801X | Yes |
Addresses
Primary practice location
510 E 2ND St
Trenton, NE 69044-1817
Mailing address
305 Circle Dr
Trenton, NE 69044-1824
Phone (316) 925-1895
Other providers in Trenton, NE
- Community Hospital Association
- Robin Cook
- Educational Service Unit 15
- Hitchcock County Schools #44-0070
- Teresa A Hodgson
- Kristina Hope Kerst
- Trenton Nursing Home - Village of Trenton
- Hayley Sue Uerling
- Village of Trenton
All providers in Trenton, NE · Personal Care Attendant in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2025. 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.