Kingma, Jackie J
Kingma, Jackie J is an individual health care provider with primary practice located at 1025 E 7Th St Hper C202, Bloomington IN 47405-7109. She recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is her primary health care specialty. Kingma, Jackie J can be contacted via phone (812) 855-1233.Contact Information
Primary practice address
1025 E 7Th St Hper C202
Bloomington IN 47405-7109
Phone: (812) 855-1233
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 05009744A | Indiana |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 36001566A | Indiana |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
NPI number | 1396718060 |
---|---|
LBN Legal business name | Kingma, Jackie J |
Credentials | DPT, ATC, PA-C, PT |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 10th, 2006 |
Last updated | Oct 15th, 2012 - about 12 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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