Jackson, Kristin

Jackson, Kristin is an individual health care provider with primary practice located at 1108 1St St Se , Little Falls MN 56345-3440. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Jackson, Kristin can be contacted via phone (320) 632-3671.

Contact Information

Primary practice address
1108 1St St Se Little Falls MN 56345-3440
Phone: (320) 632-3671
Fax: (320) 632-3728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 612 Minnesota

Profile Details

NPI number 1720037724
LBN Legal business name Jackson, Kristin
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Feb 5th, 2008 - about 16 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 1720037724 NPPES
Minnesota MEDICAID 967750000MN

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