Jaques, Gloria Simo

Jaques, Gloria Simo is an individual health care provider with primary practice located at 2500 N State St Department Of Medicine/Wound Care Gmed, Jackson MS 39216-4500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Jaques, Gloria Simo can be contacted via phone (601) 984-1000.

Contact Information

Primary practice address
2500 N State St Department Of Medicine/Wound Care Gmed Jackson MS 39216-4500
Phone: (601) 984-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X R850494 Mississippi

Profile Details

NPI number 1518219914
LBN Legal business name Jaques, Gloria Simo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 9th, 2012
Last updated Jun 18th, 2015 - about 9 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 1518219914 NPPES
Mississippi MEDICAID 06432790
Mississippi Other P01454792

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