Denise Jackson
Prosthetist
11720 Medlock Bridge Rd Ste 155
Johns Creek
, Georgia 30097
Denise Jackson
Prosthetist
11720 Medlock Bridge Rd Ste 155
Johns Creek
, Georgia 30097
(574) 320-3549
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About
Features
Specialties
- Prosthetist
Languages spoken
- English
Location
First Address
- Denise Jackson
- 11720 Medlock Bridge Rd Ste 155
- Johns Creek, GA
- Zip : 30097-1513
- Phone : (574) 320-3549
Second Address
- Denise Jackson
- 11720 Medlock Bridge Rd Ste 155
- Johns Creek, GA
- Zip : 30097
- Phone : (574) 320-3549
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 224P00000X | Prosthetist | BC29700281 | IN |
| Y | 224P00000X | Prosthetist | CO124581 | GA |
National Provider Identifier
| NPI | 1306330303 |
|---|---|
| Provider Name | Denise Jackson |
| First Address | Johns Creek, GA 30097-1513 |
| Second Address | Johns Creek, GA 30097 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/06/2018 |
| Last Update Date | 27/06/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.