Isom, Amina Jackson

Isom, Amina Jackson is an individual health care provider with primary practice located at 5671 Peachtree Dunwoody Rd Ne Suite 680, Atlanta GA 30342-5000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Isom, Amina Jackson can be contacted via phone (404) 705-6985.

Contact Information

Primary practice address
5671 Peachtree Dunwoody Rd Ne Suite 680 Atlanta GA 30342-5000
Phone: (404) 705-6985
Fax: (404) 851-9950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN063448 Georgia

Profile Details

NPI number 1225097124
LBN Legal business name Isom, Amina Jackson
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Dec 3rd, 2010 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1225097124 NPPES
Georgia MEDICAID 000556795

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