Provider Demographics
NPI:1972079051
Name:JACKSON-FRANCIS, DAISHA DIONNE
Entity Type:Individual
Prefix:
First Name:DAISHA
Middle Name:DIONNE
Last Name:JACKSON-FRANCIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAISHA
Other - Middle Name:D
Other - Last Name:JACKSON-FRANCIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1021
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-1021
Mailing Address - Country:US
Mailing Address - Phone:682-250-8990
Mailing Address - Fax:
Practice Address - Street 1:824 WOODMARK DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-1345
Practice Address - Country:US
Practice Address - Phone:682-250-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health