Jackson, Teresa A

Jackson, Teresa A is an individual health care provider with primary practice located at 4692 Nw 183Rd St , Miami Gardens FL 33055-3054. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jackson, Teresa A can be contacted via phone (305) 637-6400.

Contact Information

Primary practice address
4692 Nw 183Rd St Miami Gardens FL 33055-3054
Phone: (305) 637-6400
Fax: (305) 623-0998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2904542 Florida

Profile Details

NPI number 1528160181
LBN Legal business name Jackson, Teresa A
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2006
Last updated Sep 15th, 2016 - about 8 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 1528160181 NPPES
Florida MEDICAID 303067900

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