IndividualActive
Jacquenett Jackson
NPI 1376727388 · Adult Care Home Facility · Shubuta, MS
Provider details
- NPI number
- 1376727388
- Entity type
- Individual
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
114 Second Street
Shubuta, MS 39360
Phone: (601) 687-1128
Fax: (601) 687-5497
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 462
Shubuta, MS 39360-0462
Registry dates
- Enumerated
- 2007-12-27
- Last updated
- 2007-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.