Jackson, Elise M
Jackson, Elise M is an sole proprietor health care provider with primary practice located at 601 Childrens Ln , Norfolk VA 23507-1910. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Jackson, Elise M can be contacted via phone (757) 668-7000.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 2305206461 | Virginia |
Profile Details
| NPI number | 1932412343 |
|---|---|
| LBN Legal business name | Jackson, Elise M |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 15th, 2010 |
| Last updated | Jul 15th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932412343 | NPPES |
| Virginia | Other | 2305206461 | VIRGINIA BOARD OF PHYSICAL THERAPY LICENSE |
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