1. Home
  2. Directory
  3. Mississippi
  4. Hattiesburg
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

KESHUN JACKSON
NPI 1417590142
Student in an Organized Health Care Education/Training Program in Hattiesburg, MS

Active since October 25, 2019
203 N 25TH AVE, HATTIESBURG, MS 39401(662) 897-4719 Get Directions Write a Review

NPPES record last updated: October 25, 2019. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Keshun Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KESHUN JACKSON (NPI 1417590142) is an individual student in an organized health care education/training program in Hattiesburg, Mississippi and active in the NPI registry since October 2019.

NPPES Registry Identity

NPI1417590142
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKESHUN JACKSON
Location Address203 N 25TH AVEHattiesburg, MS 39401-5958
Mailing Address203 N 25th AveHattiesburg, MS 39401-5958 · (662) 897-4719
Phone(662) 897-4719
Sole ProprietorYes
Enumeration DateOctober 25, 2019
✔ NPI 1417590142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
203 N 25TH AVE, Hattiesburg, MS 39401
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keshun Jackson's NPI number?

The NPI number for Keshun Jackson is 1417590142. It was assigned to this individual provider in the NPPES registry on October 25, 2019.

Where is Keshun Jackson located?

Keshun Jackson practices at 203 N 25th Ave, Hattiesburg, MS 39401. The listed phone number is (662) 897-4719.

What is Keshun Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Keshun Jackson was last updated on October 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.