Jackson, Michelle

Jackson, Michelle is an sole proprietor health care provider with primary practice located at 163 Poospatuck Ln , Mastic NY 11950-5201. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Jackson, Michelle can be contacted via phone (631) 772-4622.

Contact Information

Primary practice address
163 Poospatuck Ln Mastic NY 11950-5201
Phone: (631) 772-4622
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 344797 New York
Nursing Service Providers / Registered Nurse 163W00000X 503813 New York

Profile Details

NPI number 1306095658
LBN Legal business name Jackson, Michelle
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2008
Last updated Apr 16th, 2020 - about 4 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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