Jackson, Leslie
Jackson, Leslie is an individual health care provider with primary practice located at 1835 Grant Ave , Jonesboro AR 72401-6155. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Jackson, Leslie can be contacted via phone (870) 974-9114.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | Arkansas |
Profile Details
| NPI number | 1417717422 |
|---|---|
| LBN Legal business name | Jackson, Leslie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2024 |
| Last updated | Mar 19th, 2024 - about 2 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 | 1417717422 | NPPES |
| Arkansas | MEDICAID | 290655795 |
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