Jackson, Brenda A L

Jackson, Brenda A L is an individual health care provider with primary practice located at 45-602 Kamehameha Hwy , Kaneohe HI 96744-2017. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Jackson, Brenda A L can be contacted via phone (808) 432-3800.

Contact Information

Primary practice address
45-602 Kamehameha Hwy Kaneohe HI 96744-2017
Phone: (808) 432-3800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN-89 Hawaii
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN-89 Hawaii
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X APRN-89 Hawaii

Profile Details

NPI number 1336295286
LBN Legal business name Jackson, Brenda A L
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Aug 21st, 2009 - about 16 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 1336295286 NPPES
Hawaii MEDICAID 54134302
Hawaii Other 00A0229342
Hawaii MEDICAID 61565108

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