Jackson, Kimberly Dianne Billie

Jackson, Kimberly Dianne Billie is an sole proprietor health care provider with primary practice located at 940 Morningside Dr , Sumter SC 29153-7724. She recently has 3 registered licenses in different health care specialties including Laboratories / Clinical Medical Laboratory, Ambulatory Health Care Facilities / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Ambulatory Health Care Facilities / Community Health is her primary health care specialty. Jackson, Kimberly Dianne Billie can be contacted via phone (914) 359-7442.

Contact Information

Primary practice address
940 Morningside Dr Sumter SC 29153-7724
Phone: (914) 359-7442
Fax: (803) 883-4087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X 23707 South Carolina
Ambulatory Health Care Facilities / Community Health 261QC1500X APN.23707 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APN.23707 South Carolina

Profile Details

NPI number 1588293278
LBN Legal business name Jackson, Kimberly Dianne Billie
Credentials AGNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2020
Last updated Dec 27th, 2021 - about 4 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 1588293278 NPPES
Other AG01200075 AANP CERTIFICATION NUMBER
Other AG01200075 AANP CERTIFICATION NUMBER

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