Martin, Jacqueline Wilson
Martin, Jacqueline Wilson is an sole proprietor health care provider with primary practice located at 538 Warriner St , Reidsville NC 27320-3053. She recently has only one registered license in Other Service Providers / Lodging, which is considered as her primary health care specialty. Martin, Jacqueline Wilson can be contacted via phone (336) 348-6902.Contact Information
Primary practice address
538 Warriner St
Reidsville NC 27320-3053
Phone: (336) 348-6902
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Lodging | 177F00000X | FCL-079-037 | North Carolina |
Profile Details
| NPI number | 1073667226 |
|---|---|
| LBN Legal business name | Martin, Jacqueline Wilson |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 23rd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1073667226 | NPPES |
| North Carolina | MEDICAID | 7803777 |
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