Jackson, Terri

Jackson, Terri is an individual health care provider with primary practice located at 3015 N Ballas Rd , Saint Louis MO 63131-2329. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Jackson, Terri can be contacted via phone (314) 996-5330.

Contact Information

Primary practice address
3015 N Ballas Rd Saint Louis MO 63131-2329
Phone: (314) 996-5330
Fax: (314) 810-1399
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 126514 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 126514 Missouri

Profile Details

NPI number 1023080199
LBN Legal business name Jackson, Terri
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Aug 22nd, 2017 - about 7 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1023080199 NPPES
Missouri MEDICAID 918437401
Missouri Other P00161434

Popular Providers