Jackson, Claudette F

Jackson, Claudette F is an individual health care provider with primary practice located at 13782 Plantation Rd Ste 201 , Fort Myers FL 33912-4462. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Claudette F can be contacted via phone (239) 343-1100.

Contact Information

Primary practice address
13782 Plantation Rd Ste 201 Fort Myers FL 33912-4462
Phone: (239) 343-1100
Fax: (239) 343-1101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9109552 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA902 Kentucky

Profile Details

NPI number 1962494450
LBN Legal business name Jackson, Claudette F
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Apr 18th, 2022 - about 2 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 1962494450 NPPES
Kentucky Other 000000595343 BCBS
Kentucky MEDICAID 113774800 BCBS
Kentucky Other P00706704 BCBS

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