Jackson, Vanessa Rachel
Jackson, Vanessa Rachel is an individual health care provider with primary practice located at 728 Gaffney Rd Suite 100, Fairbanks AK 99701-4610. She recently has only one registered license in Other Service Providers / Midwife, which is considered as her primary health care specialty. Jackson, Vanessa Rachel can be contacted via phone (907) 456-3719.Contact Information
Primary practice address
728 Gaffney Rd Suite 100
Fairbanks AK 99701-4610
Phone: (907) 456-3719
Fax: (907) 456-1511
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Midwife | 176B00000X | AA42 | Alaska |
Profile Details
| NPI number | 1497888572 |
|---|---|
| LBN Legal business name | Jackson, Vanessa Rachel |
| Credentials | CDM |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2007 |
| Last updated | Nov 6th, 2012 - about 13 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 | 1497888572 | NPPES |
| Alaska | MEDICAID | NM0042 | |
| Alaska | Other | AA42 |
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