Jackson, Stephanie Colleen
Jackson, Stephanie Colleen is an sole proprietor health care provider with primary practice located at 275 10Th St Se Ste 3320 , Cedar Rapids IA 52403-2450. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Jackson, Stephanie Colleen can be contacted via phone (319) 398-1721.Contact Information
Primary practice address
275 10Th St Se Ste 3320
Cedar Rapids IA 52403-2450
Phone: (319) 398-1721
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 1252071 | Iowa |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 14922 | Nevada |
Profile Details
| NPI number | 1013177872 |
|---|---|
| LBN Legal business name | Jackson, Stephanie Colleen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2008 |
| Last updated | Apr 2nd, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013177872 | NPPES |
| Nevada | Other | 14922 | MEDICAL LICENSE |
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