Jackson, Lorraine Helena Mary

Jackson, Lorraine Helena Mary is an individual health care provider with primary practice located at 1715 Dousman St , Green Bay WI 54303-3211. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Jackson, Lorraine Helena Mary can be contacted via phone (920) 496-4700.

Contact Information

Primary practice address
1715 Dousman St Green Bay WI 54303-3211
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 32894 Wisconsin
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 32894-020 Wisconsin

Profile Details

NPI number 1447348479
LBN Legal business name Jackson, Lorraine Helena Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Jun 8th, 2015 - about 9 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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