Most Relevant Information
Provider Data
| NPI Number: | 1003513417 |
| Provider Name: | MERISSA JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/15/2023 |
| Last Updated: | 02/15/2023 |
Provider Practice Location
1440 E EMPIRE AVE
BENTON HARBOR
MI
490222020
Practice Location Phone/Fax
| Phone: | 2694879820 |
| Fax: |
Provider Mailing Location
1440 E EMPIRE AVE
BENTON HARBOR
MI
490222020
Provider Mailing Phone/Fax
| Phone: | 2694879820 |
| Fax: |