Jackson, Bennett J

Jackson, Bennett J is an individual health care provider with primary practice located at 6307 Debarr Rd Ste C , Anchorage AK 99504-1783. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Jackson, Bennett J can be contacted via phone (907) 333-7425.

Contact Information

Primary practice address
6307 Debarr Rd Ste C Anchorage AK 99504-1783
Phone: (907) 333-7425
Fax: (907) 333-7719
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 666 Alaska

Profile Details

NPI number 1568523157
LBN Legal business name Jackson, Bennett J
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jul 9th, 2007 - about 19 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 1568523157 NPPES
Alaska Other 1730113739 GROUP NPI
Alaska MEDICAID NP39831 GROUP NPI

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