Jackson, Avril Delores

Jackson, Avril Delores is an sole proprietor health care provider with primary practice located at 3310 Ave H Apt 2L, Brooklyn NY 11210. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Jackson, Avril Delores can be contacted via phone (718) 434-4659.

Contact Information

Primary practice address
3310 Ave H Apt 2L Brooklyn NY 11210
Phone: (718) 434-4659
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 2789001 New York

Profile Details

NPI number 1710174040
LBN Legal business name Jackson, Avril Delores
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2007
Last updated Oct 1st, 2007 - about 17 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 1710174040 NPPES
New York MEDICAID 02667458

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