Jackson, Nancy

Jackson, Nancy is an individual health care provider with primary practice located at 1115 Garredd Blvd , Augusta GA 30909. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Jackson, Nancy can be contacted via phone (706) 854-9416.

Contact Information

Primary practice address
1115 Garredd Blvd Augusta GA 30909
Phone: (706) 854-9416
Fax: (706) 863-8523
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R110128 Georgia

Profile Details

NPI number 1487615191
LBN Legal business name Jackson, Nancy
Credentials RN PNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jul 8th, 2007 - about 17 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 1487615191 NPPES
Georgia MEDICAID 00876939A

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