Jackman, Kim Rene

Jackman, Kim Rene is an sole proprietor health care provider with primary practice located at 524 Jefferson Ave , Rockville Centre NY 11570-3312. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Jackman, Kim Rene can be contacted via phone (516) 255-4699.

Contact Information

Primary practice address
524 Jefferson Ave Rockville Centre NY 11570-3312
Phone: (516) 255-4699
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 246730 New York

Profile Details

NPI number 1568795573
LBN Legal business name Jackman, Kim Rene
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2009
Last updated Sep 9th, 2009 - about 15 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 1568795573 NPPES
New York MEDICAID 246730

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