| Doctor Name: | DARLENE JACKSON |
| NPI Number: | 1508240854 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 104 |
| Business Practice Address: | 97 Knobs Lane Cedar Bluff, VA - 246093205 |
| Business Phone Number: | 2768802330 |
| Business Fax Number: | 2768802329 |
| Mailing Address: | Po Box 2016, LEBANON |
| State: | VA |
| Postal Code: | 242662016 |
| Phone Number: | 2768802330 |
| Fax Number: | 2768802329 |
| NPI Enumeration Date: | 07/16/2015 |
| NPI Last Update Date: | 07/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 344600000X |
| License Number: | 104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Taxi |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set forth by the jurisdictions where it is located. |