Jackson, Kimberley Evelyn

Jackson, Kimberley Evelyn is an individual health care provider with primary practice located at 902 Lakeview Ave , Pueblo CO 81004-3597. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Jackson, Kimberley Evelyn can be contacted via phone (719) 557-5855.

Contact Information

Primary practice address
902 Lakeview Ave Pueblo CO 81004-3597
Phone: (719) 557-5855
Fax: (719) 557-4690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X OS014960 Pennsylvania

Profile Details

NPI number 1154586832
LBN Legal business name Jackson, Kimberley Evelyn
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2008
Last updated Sep 16th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154586832 NPPES
Pennsylvania Other OS014960 PENNSYLVANIA OSTEOPATHIC MEDICAL BOARD
Pennsylvania Other 50533 PENNSYLVANIA OSTEOPATHIC MEDICAL BOARD

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