Provider Demographics
NPI:1760250948
Name:JACKSON, APRIL MICHELLE
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:MICHELLE
Last Name:JACKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2633
Mailing Address - Country:US
Mailing Address - Phone:803-785-5001
Mailing Address - Fax:803-479-4343
Practice Address - Street 1:203 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2633
Practice Address - Country:US
Practice Address - Phone:803-785-5001
Practice Address - Fax:803-479-4343
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide