NPI 1073237350 · live from the CMS NPI Registry
Celia Anderson Jackson
Technician, Attendant Care Provider in Columbia, SC. National Provider Identifier 1073237350, active.
NPI record
| NPI | 1073237350 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Technician, Attendant Care Provider 3747A0650X |
| Practice location | 2441 Atlas Road, Columbia, SC 29209 |
| Practice phone | 404-803-3805 |
| Mailing address | 127 Lateesha Rd, Hopkins, SC 29061 |
| Enumerated | September 29, 2022 |
| Last updated | December 4, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Worker | 172V00000X | — |
| Home Health | 251E00000X | — |
| Custodial Care Facility, Adult Care Home | 311ZA0620X | — |
| Technician, Personal Care Attendant | 3747P1801X | — |
| Home Health Aide | 374U00000X | — |
| Technician, Attendant Care Provider primary | 3747A0650X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.