Jackson Ii, Willie

Jackson Ii, Willie is an sole proprietor health care provider with primary practice located at 1860 Memory Ln , Jacksonville FL 32210-1308. He recently has only one registered license in Nursing Service Related Providers / Day Training/Habilitation Specialist, which is considered as his primary health care specialty. Jackson Ii, Willie can be contacted via phone (904) 265-0340.

Contact Information

Primary practice address
1860 Memory Ln Jacksonville FL 32210-1308
Phone: (904) 265-0340
Fax: (904) 265-1906
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X

Profile Details

NPI number 1700995792
LBN Legal business name Jackson Ii, Willie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 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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