Jackson, Shirley Jean

Jackson, Shirley Jean is an sole proprietor health care provider with primary practice located at 21 North Atwood Ave , Janesville WI 53648. She recently has only one registered license in Nursing Service Providers / Home Health, which is considered as her primary health care specialty. Jackson, Shirley Jean can be contacted via phone (608) 931-4477.

Contact Information

Primary practice address
21 North Atwood Ave Janesville WI 53648
Phone: (608) 931-4477
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Home Health 163WH0200X Wisconsin

Profile Details

NPI number 1538218292
LBN Legal business name Jackson, Shirley Jean
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2007
Last updated Mar 19th, 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 1538218292 NPPES
Wisconsin MEDICAID 39916200

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