Jackson, Deborah L

Jackson, Deborah L is an individual health care provider with primary practice located at 1163 Country Club Road , Monongahela PA 15063-1095. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Jackson, Deborah L can be contacted via phone (724) 258-1085.

Contact Information

Primary practice address
1163 Country Club Road Monongahela PA 15063-1095
Phone: (724) 258-1085
Fax: (724) 258-1394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN186507L Pennsylvania

Profile Details

NPI number 1578652525
LBN Legal business name Jackson, Deborah L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Jul 9th, 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 1578652525 NPPES
Pennsylvania Other JA706895 BLUE SHIELD
Pennsylvania Other 217541 BLUE SHIELD

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