Jackson, Chanell Shannon

Jackson, Chanell Shannon is an individual health care provider with primary practice located at 5883 1/2 Doverwood Dr , Culver City CA 90230-7203. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Other Service Providers / Midwife. Other Service Providers / Midwife is her primary health care specialty. Jackson, Chanell Shannon can be contacted via phone (310) 848-7736.

Contact Information

Primary practice address
5883 1/2 Doverwood Dr Culver City CA 90230-7203
Phone: (310) 848-7736
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 236061 California
Other Service Providers / Midwife 176B00000X 236061 California

Profile Details

NPI number 1356011597
LBN Legal business name Jackson, Chanell Shannon
Credentials NMW, WHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2021
Last updated Mar 30th, 2022 - about 3 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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