KESHUN JACKSON (NPI# 1417590142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417590142 |
| Entity Type | Individual |
| Full Name | KESHUN JACKSON |
| Practice Address |
203 N 25th Ave Hattiesburg MS 39401-5958 |
| Practice Telephone | 6628974719 |
| Mailing Telephone | 6628974719 |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-10-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
203 N 25TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-5958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420092 | Merrick Greene Jackson | Student in an Organized Health Care Education/Training Program | 120 Natalie Ln, Hattiesburg, MS 39402-3080 | 2020-09-07 |
| 1730709627 | Logan Armond Wilson | Student in an Organized Health Care Education/Training Program | 301 Romar Pl, Hattiesburg, MS 39402-1299 | 2020-04-21 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1609338318 | Naimish Mehta | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street - Merit Health Wesley, Hattiesburg, MS 39602 | 2019-04-02 |
| 1245690551 | Dustin Kilpatrick | Student in an Organized Health Care Education/Training Program | 111 Breckenridge Dr, Apt 304, Hattiesburg, MS 39402-7324 | 2016-02-29 |
| 1982211496 | Jessica Lero | Student in an Organized Health Care Education/Training Program | 118 College Dr, Hattiesburg, MS 39406-0002 | 2020-09-29 |
| 1578170429 | Ranesha Cook | Student in an Organized Health Care Education/Training Program | 118 College Dr, Hattiesburg, MS 39406-0002 | 2020-09-24 |
| 1437766540 | Trinity Latrice Mcclain | Student in an Organized Health Care Education/Training Program | 118 College Dr, Hattiesburg, MS 39406-0002 | 2020-09-23 |
| 1255947461 | Madison Grace Mitchell | Student in an Organized Health Care Education/Training Program | 118 College Dr, Hattiesburg, MS 39406-0002 | 2020-09-22 |
| 1346852118 | Cristy Collins | Student in an Organized Health Care Education/Training Program | 118 College Dr, Hattiesburg, MS 39406-0001 | 2020-08-21 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.