Jackson, Mary L.

Jackson, Mary L. is an individual health care provider with primary practice located at 3822 N 27Th St , Milwaukee WI 53216-2608. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Jackson, Mary L. can be contacted via phone (414) 444-9235.

Contact Information

Primary practice address
3822 N 27Th St Milwaukee WI 53216-2608
Phone: (414) 444-9235
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 34317031 Wisconsin

Profile Details

NPI number 1750340329
LBN Legal business name Jackson, Mary L.
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Feb 29th, 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 1750340329 NPPES
Wisconsin Other 39975900 PROVIDER NUMBER

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