Jackson, Stefanie M

Jackson, Stefanie M is an individual health care provider with primary practice located at 1289 Sw State Road 47 , Lake City FL 32025-0484. 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, Stefanie M can be contacted via phone (386) 755-0421.

Contact Information

Primary practice address
1289 Sw State Road 47 Lake City FL 32025-0484
Phone: (386) 755-0421
Fax: (386) 487-1234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP 2620432 Florida

Profile Details

NPI number 1346204427
LBN Legal business name Jackson, Stefanie M
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jun 25th, 2010 - about 14 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 1346204427 NPPES
Florida Other ARNP2620432 MEDICAL LICENSE
Florida Other 275262 MEDICAL LICENSE
Florida Other 363L00000X MEDICAL LICENSE
Florida Other DE000Z MEDICAL LICENSE

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