Foreman, Jackie D.

Foreman, Jackie D. is an individual health care provider with primary practice located at 731 S Avenue 59 , Los Angeles CA 90042-5003. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Foreman, Jackie D. can be contacted via phone (620) 875-6462.

Contact Information

Primary practice address
731 S Avenue 59 Los Angeles CA 90042-5003
Phone: (620) 875-6462
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 139057 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP 19781 California

Profile Details

NPI number 1972547735
LBN Legal business name Foreman, Jackie D.
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Apr 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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