Provider Demographics
NPI:1609570878
Name:JACKSON, ERYKA (CPR/BLS)
Entity Type:Individual
Prefix:
First Name:ERYKA
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:CPR/BLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 WAYNE ST UNIT 3205
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2397
Mailing Address - Country:US
Mailing Address - Phone:513-678-1049
Mailing Address - Fax:
Practice Address - Street 1:722 WAYNE ST UNIT 3205
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2397
Practice Address - Country:US
Practice Address - Phone:513-678-1049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker