Jackson, Julliet
Jackson, Julliet is an sole proprietor health care provider with primary practice located at 17345 Edgewater Dr , Port Charlotte FL 33948-2343. She recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as her primary health care specialty. Jackson, Julliet can be contacted via phone (941) 766-0175.Contact Information
Primary practice address
17345 Edgewater Dr
Port Charlotte FL 33948-2343
Phone: (941) 766-0175
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Adult Care Home | 311ZA0620X | 6905617 | Florida |
Profile Details
| NPI number | 1922438464 |
|---|---|
| LBN Legal business name | Jackson, Julliet |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2013 |
| Last updated | Nov 20th, 2013 - about 12 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 | 1922438464 | NPPES |
| Florida | MEDICAID | 142038100 |
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