Jackson, Cheryl Anne
Jackson, Cheryl Anne is an individual health care provider with primary practice located at 401 Shickshinney Lake Road , Huntington Mills PA 18622-0046. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Cheryl Anne can be contacted via phone (570) 864-3191.Contact Information
Primary practice address
401 Shickshinney Lake Road
Huntington Mills PA 18622-0046
Phone: (570) 864-3191
Fax: (570) 864-2569
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | VP005790B | Pennsylvania |
Profile Details
| NPI number | 1831165166 |
|---|---|
| LBN Legal business name | Jackson, Cheryl Anne |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2006 |
| Last updated | Nov 5th, 2009 - 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 | 1831165166 | NPPES |
| Pennsylvania | Other | 50072326 | KEYSTONE CBC |
| Pennsylvania | MEDICAID | 1019794280001 | KEYSTONE CBC |
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