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

Shavonta Jackson, CNA

Individual provider Nurse's Aide · NPI 1336883602

Shavonta Jackson, CNA is a Nurse's Aide in Stone Mountain, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2022

Practice location Address checks out

1607 Barrington Vw
Stone Mountain, GA 30087-1846
Phone: (678) 582-9317
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse's Aide (primary) Taxonomy 376K00000X · Licence CN0028901061 (GA)

Record details

NPI number1336883602
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNA
Sole proprietorYes
NPI enumeratedApril 23, 2022
Last updated in NPPESApril 23, 2022
Certification dateApril 23, 2022
Mailing address1607 Barrington Vw, Stone Mountain, GA 30087-1846

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