Princiotta, Jonathan

Princiotta, Jonathan is an individual health care provider with primary practice located at 2500 N State St 2500 North State Street, Jackson MS 39216-4500. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, which is considered as his primary health care specialty. Princiotta, Jonathan can be contacted via phone (601) 815-6960.

Contact Information

Primary practice address
2500 N State St 2500 North State Street Jackson MS 39216-4500
Phone: (601) 815-6960
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X 901958 Mississippi

Profile Details

NPI number 1215476064
LBN Legal business name Princiotta, Jonathan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2017
Last updated Apr 5th, 2017 - about 7 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 1215476064 NPPES
Mississippi MEDICAID 05103351

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