Jackson, Angela Allen

Jackson, Angela Allen is an individual health care provider with primary practice located at 1010 Lakeland Pl , Flowood MS 39232-6678. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Jackson, Angela Allen can be contacted via phone (601) 815-0600.

Contact Information

Primary practice address
1010 Lakeland Pl Flowood MS 39232-6678
Phone: (601) 815-0600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R873582 Mississippi

Profile Details

NPI number 1841505567
LBN Legal business name Jackson, Angela Allen
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2010
Last updated Oct 6th, 2017 - about 7 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 1841505567 NPPES
Mississippi MEDICAID 05728527

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