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Laverne Jackson
Primary Care Clinic/Center in Quitman, Georgia
NPI 1134593353

Laverne Jackson is a Primary Care Clinic/Center based in Quitman, GA and is specialized in Primary Care. Laverne Jackson practices in Quitman, GA. The NPI Number for Laverne Jackson is 1134593353 and holds a License No. RN130090 (Georgia).

The current practice location address for Laverne Jackson is 903 N Court St, Quitman, GA and can be reached out via phone at 229-263-7147 and via fax at 229-263-6318.

Location: 903 N Court St, Quitman, GA, 31643-1315
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134593353
Provider Name
Laverne Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
903 N Court St, Quitman, GA, 31643-1315
Phone Number
229-263-7147
Fax Number
229-263-6318
Provider Enumeration Date
11/27/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
RN130090 01 GA PROFESSIONAL REGISTERED NURSE
institution
Provider Business Practice Location Address Details
Address
903 N Court St
City
Quitman
State
Georgia
Zip
31643-1315
Phone Number
229-263-7147
Fax Number
229-263-6318
person
Provider Business Mailing Address Details
Address
903 N Court St
City
Quitman
State
Georgia
Zip
31643-1315
Phone Number
229-263-7147
Fax Number
229-263-6318
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
RN130090 (Georgia)
Definition
Definition to come...
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