Penn, Jackie Ijeoma

Penn, Jackie Ijeoma is an sole proprietor health care provider with primary practice located at 5319 Nueces Ln , Grand Prairie TX 75052-2667. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Penn, Jackie Ijeoma can be contacted via phone (214) 584-4103.

Contact Information

Primary practice address
5319 Nueces Ln Grand Prairie TX 75052-2667
Phone: (214) 584-4103
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 783349 Texas
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 1056737 Texas

Profile Details

NPI number 1972940260
LBN Legal business name Penn, Jackie Ijeoma
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 28th, 2013
Last updated May 3rd, 2024 - about last year

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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