Emily Jackson

Individual provider Active NPI Attendant Care Provider · Locust Grove, VA

NPI 1295489276 · NPPES record last updated Feb 8, 2022

Key facts

NPI
1295489276
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
1200 Lakeview Pkwy
Locust Grove, VA 22508-5232
Phone
(540) 220-5261
NPI assigned
Feb 8, 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)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X VA Yes

Addresses

Primary practice location

1200 Lakeview Pkwy
Locust Grove, VA 22508-5232

Mailing address

1200 Lakeview Pkwy
Locust Grove, VA 22508-5232
Phone (540) 220-5261

Electronic endpoints

TypeEndpointUseAffiliation
Other URL n/a

Other providers in Locust Grove, VA

All providers in Locust Grove, VA · Attendant Care Provider in Virginia

Sources for this page

Verify at the official NPI Registry.