Jackson, Deborah

Jackson, Deborah is an individual health care provider with primary practice located at 8875 Centre Park Dr Suite D, Columbia MD 21045-2114. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Jackson, Deborah can be contacted via phone (410) 730-1000.

Contact Information

Primary practice address
8875 Centre Park Dr Suite D Columbia MD 21045-2114
Phone: (410) 730-1000
Fax: (410) 730-8615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X R048240 Maryland

Profile Details

NPI number 1356436273
LBN Legal business name Jackson, Deborah
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Dec 1st, 2008 - 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 1356436273 NPPES
Maryland Other 63697401 BLUE SHIELD
Maryland Other C4280003 BLUE SHIELD

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