Jackson, Keilon Latrice

Jackson, Keilon Latrice is an sole proprietor health care provider with primary practice located at 511 Downing St , Lawrenceville GA 30045-4597. She recently has 3 registered licenses in different health care specialties including Nursing Service Related Providers / Adult Companion, Nursing Service Related Providers / Home Health Aide, Nursing Service Related Providers / Nurse's Aide. Nursing Service Related Providers / Home Health Aide is her primary health care specialty. Jackson, Keilon Latrice can be contacted via phone (678) 577-9097.

Contact Information

Primary practice address
511 Downing St Lawrenceville GA 30045-4597
Phone: (678) 577-9097
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Adult Companion 372600000X 20019336068 Georgia
Nursing Service Related Providers / Home Health Aide 374U00000X 20019336068 Georgia
Nursing Service Related Providers / Nurse's Aide 376K00000X 20019336068 Georgia

Profile Details

NPI number 1285852764
LBN Legal business name Jackson, Keilon Latrice
Credentials Certified Medical Assistant (CMA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2007
Last updated Jan 5th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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