Jackson, Waylon Colby

Jackson, Waylon Colby is an sole proprietor health care provider with primary practice located at 701 N 1St St , Springfield IL 62781-0001. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Jackson, Waylon Colby can be contacted via phone (217) 788-3755.

Contact Information

Primary practice address
701 N 1St St Springfield IL 62781-0001
Phone: (217) 788-3755
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X 2002014595 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X 20071425 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209011241 Illinois

Profile Details

NPI number 1548443146
LBN Legal business name Jackson, Waylon Colby
Credentials CRNA, CPNP-AC, CCRN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2007
Last updated Oct 31st, 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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