Jackson, Laura Lynn

Jackson, Laura Lynn is an individual health care provider with primary practice located at 2630 E Citizens Dr Ste 3 , Fayetteville AR 72703-4797. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Jackson, Laura Lynn can be contacted via phone (479) 527-9966.

Contact Information

Primary practice address
2630 E Citizens Dr Ste 3 Fayetteville AR 72703-4797
Phone: (479) 527-9966
Fax: (479) 527-9677
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X Arkansas

Profile Details

NPI number 1770817421
LBN Legal business name Jackson, Laura Lynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2009
Last updated Jan 21st, 2021 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1770817421 NPPES
Oklahoma MEDICAID 200616270A
Oklahoma MEDICAID 190941795

Popular Providers