MICHELLE MARTINE JACKSON

Debarred entity

Born 28 Sep 1966 (60 years old),United States. Named in 2 sanctions listings.

Sanctions and listings2

Effective
19 Jan 2023
Official designation
Mississippi Division of MedicaidUS Mississippi Medicaid Terminated Provider ListUnited States
Criminal Conduct
medicaid.ms.gov
Effective
19 Jan 2023
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a1
Programme US-HHS-OIGoig.hhs.gov oig.hhs.gov

Positions held1

Period not retained
INTERNAL MEDICINE (PHYSICIAN (MD, DO))

Identifiers1

Identifier	Number
NPI number	1568479715

Other names1

Also known as1

Michelle S Jackson

Addresses2

5621 Cottage Hill Road
P O BOX 7007, 05967-509, MARIANNA, FL 32447

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