Jackson, Marnie
Jackson, Marnie is an individual health care provider with primary practice located at 800 Jeffery St Apt 101 , Boca Raton FL 33487-4165. She recently has 4 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology, Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is her primary health care specialty. Jackson, Marnie can be contacted via phone (561) 397-2888.Contact Information
Primary practice address
800 Jeffery St Apt 101
Boca Raton FL 33487-4165
Phone: (561) 397-2888
Fax: (561) 397-2888
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Anesthesiology | 207LP3000X | N0852 | Texas |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | N0852 | Texas |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | N0852 | Texas |
Profile Details
| NPI number | 1881805034 |
|---|---|
| LBN Legal business name | Jackson, Marnie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2007 |
| Last updated | Mar 31st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881805034 | NPPES |
| Texas | Other | N0852 | STATE LIC |
| Texas | Other | 8BX291 | STATE LIC |
| Texas | Other | BP1-0018388 | STATE LIC |
| Texas | MEDICAID | 197710003 | STATE LIC |
| Texas | MEDICAID | 197710005 | STATE LIC |
| Texas | Other | 197710006 | STATE LIC |
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