KEWUAN DESHAUN JACKSON (NPI# 1639300874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639300874 |
| Entity Type | Individual |
| Full Name | KEWUAN DESHAUN JACKSON |
| Practice Address |
4880 N Sabino Canyon Rd Apt 14160 Tucson AZ 85750-7006 |
| Practice Telephone | 5208184318 |
| Mailing Telephone | 5208184318 |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2009-08-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
1490923 | AZ | Respite Care Facility |
| Street Address |
4880 N SABINO CANYON RD APT 14160 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85750-7006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932479870 | Deon Denise Madsen | Military Health Care Provider | 4880 N Sabino Canyon Rd, #17176, Tucson, AZ 58750 | 2012-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972125490 | Arizona Medical Specialty Group, LLC | Nurse Practitioner | 5590 E River Rd., Suite 101, Tucson, AZ 85750 | 2020-05-07 |
| 1962858936 | Honu Counseling Pllc | Community/Behavioral Health | 5855 North Kolb Road Unit 4208, Tucson, AZ 85750 | 2016-05-10 |
| 1750653341 | Patricia Jean Heese | Occupational Therapist | 5410 N Grey Moutain Tr, Tucson, AZ 85750 | 2012-01-30 |
| 1184911257 | Collaborative Associates In Surgical Assisting | Registered Nurse | 5601 E. Camino Del Celador, Tucson, AZ 85750 | 2011-07-08 |
| 1841468584 | Shelly Kay Surber | Nurse Practitioner | Minute Clinic, 6895 E Sunrise Dr., Tucson, AZ 85750 | 2008-02-15 |
| 1982788121 | Laurie Beth Weston | Psychiatry & Neurology | 7921 E Presidio Road, Tucson, AZ 85750 | 2006-10-24 |
| 1518050624 | David Stuart Thompson | Psychiatry & Neurology | 5661 East Shadow View Ct, Tucson, AZ 85750 | 2006-10-02 |
| 1043250541 | Cathy Evelyn Wayand | Registered Nurse | 6890 E Sunrise Drive Ste 120 #223, Tucson, AZ 85750 | 2006-06-07 |
| 1144206806 | John Daniel Mcarthur | Radiology | 5965 N Sabino Shadow Ln, Tucson, AZ 85750 | 2005-12-15 |
| 1972599181 | Howard Hunter Yost | Psychiatry & Neurology | 5520 N Waterfield Dr, Tucson, AZ 85750 | 2005-09-22 |
| Find all providers in zip 85750 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912539941 | Elizabeth Ann Mannel | Respite Care | 1225 W Panorama Rd, Tucson, AZ 85704-2834 | 2020-02-07 |
| 1366097073 | Lisa Ann Harper | Respite Care | 6910 N Sanders Rd, Tucson, AZ 85743-8174 | 2019-08-08 |
| 1699329904 | Robin Allen | Respite Care | 9390 N Jessy Ln, Tucson, AZ 85742-9124 | 2019-07-25 |
| 1558859447 | Veronica Molina-hubbard | Respite Care | 3131 W Los Reales Rd, Tucson, AZ 85746-8232 | 2018-04-25 |
| 1154827830 | Ola Mt Bakir | Respite Care | 9503 N Stonebrook Dr, Tucson, AZ 85743-5488 | 2018-04-02 |
| 1922513068 | Casey Partiz | Respite Care | 2625 N Norton Ave, Tucson, AZ 85719-3234 | 2017-12-12 |
| 1619492121 | Marquie L. Walker | Respite Care | 5121 E 29th St Apt 125, Tucson, AZ 85711-5802 | 2017-08-04 |
| 1720532203 | Roseanna Gonzalez | Respite Care | 5545 S Cassia Way, Tucson, AZ 85706-3409 | 2016-08-12 |
| 1871957001 | Arizona's Children Association | Respite Care | 3716 E Columbia St Ste 120, Tucson, AZ 85714-3414 | 2016-04-13 |
| 1902262173 | Luz Vasquez | Respite Care | 1929 S Magnolia Ave, Tucson, AZ 85711-6531 | 2016-01-04 |
| Find all providers in TUCSON | ||||
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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.