Jackson, Sharon L

Jackson, Sharon L is an individual health care provider with primary practice located at 327 Medical Park Dr Anesthesia Dept, Bridgeport WV 26330-9006. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Jackson, Sharon L can be contacted via phone (681) 342-1610.

Contact Information

Primary practice address
327 Medical Park Dr Anesthesia Dept Bridgeport WV 26330-9006
Phone: (681) 342-1610
Fax: (681) 342-1626
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 36091 West Virginia

Profile Details

NPI number 1366594095
LBN Legal business name Jackson, Sharon L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Jan 16th, 2018 - about 7 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 1366594095 NPPES
West Virginia MEDICAID 0069487000

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