Jackson, Andria
Jackson, Andria is an sole proprietor health care provider with primary practice located at 9560 Marlboro Pike Ste 105 , Upper Marlboro MD 20772-3770. She recently has only one registered license in Other Service Providers / Prosthetics Case Management, which is considered as her primary health care specialty. Jackson, Andria can be contacted via phone (301) 535-7542.Contact Information
Primary practice address
9560 Marlboro Pike Ste 105
Upper Marlboro MD 20772-3770
Phone: (301) 535-7542
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prosthetics Case Management | 1744P3200X | 407120 | Maryland |
Profile Details
| NPI number | 1073138285 |
|---|---|
| LBN Legal business name | Jackson, Andria |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2020 |
| Last updated | Jun 12th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073138285 | NPPES |
| Maryland | Other | 407120 | COSMETOLOGY LICENCE |
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