Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Atavia Jackson, ST

Individual provider Contractor · NPI 1528550209

Atavia Jackson, ST is a Contractor in Morven, Georgia. Practices as a sole proprietor. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

5229 Jackson Rd
Morven, GA 31638-3934
Phone: (229) 561-5507
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1528550209
Entity typeIndividual (Type 1)
GenderFemale
Credentials ST
Sole proprietorYes
NPI enumeratedMay 30, 2018
Last updated in NPPESMay 30, 2018
Mailing address5229 Jackson Rd, Morven, GA 31638-3934

Other providers in Morven