Provider Demographics
NPI:1275250003
Name:JACKSON, TARSHETA
Entity type:Individual
Prefix:MS
First Name:TARSHETA
Middle Name:
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:PO BOX 89381
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33689-0406
Mailing Address - Country:US
Mailing Address - Phone:813-706-9525
Mailing Address - Fax:813-742-1330
Practice Address - Street 1:PO BOX 89381
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33689-0406
Practice Address - Country:US
Practice Address - Phone:813-706-9525
Practice Address - Fax:813-742-1330
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy