Jackson, Tameatrice Michelle

Jackson, Tameatrice Michelle is an sole proprietor health care provider with primary practice located at 2506 Chestnut Springs Ln , Jacksonville FL 32246-1323. She recently has only one registered license in Nursing Service Related Providers / Religious Nonmedical Nursing Personnel, which is considered as her primary health care specialty. Jackson, Tameatrice Michelle can be contacted via phone (904) 382-1793.

Contact Information

Primary practice address
2506 Chestnut Springs Ln Jacksonville FL 32246-1323
Phone: (904) 382-1793
Fax: (904) 253-6759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Religious Nonmedical Nursing Personnel 374T00000X RN9255446 Florida

Profile Details

NPI number 1386801421
LBN Legal business name Jackson, Tameatrice Michelle
Credentials RN/CRT
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2008
Last updated May 16th, 2008 - 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 1386801421 NPPES
Florida MEDICAID 693464196

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