Jackson, Tonda P

Jackson, Tonda P is an individual health care provider with primary practice located at 4100 N Main St Ste 102 , Columbia SC 29203-5800. 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, Tonda P can be contacted via phone (803) 223-9895.

Contact Information

Primary practice address
4100 N Main St Ste 102 Columbia SC 29203-5800
Phone: (803) 223-9895
Fax: (803) 735-3641
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN883 South Carolina

Profile Details

NPI number 1184690174
LBN Legal business name Jackson, Tonda P
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated May 6th, 2024 - about 7 months 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 1184690174 NPPES
South Carolina MEDICAID NP0831

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