Jackson, Ikishia N

Jackson, Ikishia N is an sole proprietor health care provider with primary practice located at 625 E Girard Ave Apt 1 , Philadelphia PA 19125-3400. She recently has 9 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Home Health, Agencies / Case Management, Agencies / Home Health, Hospitals / Religious Nonmedical Health Care Institution, Transportation Services / Non-emergency Medical Transport (VAN), Nursing Service Related Providers / Home Health Aide, Nursing Service Related Providers / Homemaker, Respite Care Facility / Respite Care. Agencies / Home Health is her primary health care specialty. Jackson, Ikishia N can be contacted via phone (267) 439-0966.

Contact Information

Primary practice address
625 E Girard Ave Apt 1 Philadelphia PA 19125-3400
Phone: (267) 439-0966
Fax: (215) 425-4414
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 06650501 Pennsylvania
Nursing Service Providers / Home Health 163WH0200X 06650501 Pennsylvania
Agencies / Case Management 251B00000X 06650501 Pennsylvania
Agencies / Home Health 251E00000X 06650501 Pennsylvania
Hospitals / Religious Nonmedical Health Care Institution 282J00000X 06650501 Pennsylvania
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X 06650501 Pennsylvania
Nursing Service Related Providers / Home Health Aide 374U00000X 06650501 Pennsylvania
Nursing Service Related Providers / Homemaker 376J00000X 06650501 Pennsylvania
Respite Care Facility / Respite Care 385H00000X 06650501 Pennsylvania
Agencies / Home Health 251E00000X 652238 Pennsylvania

Profile Details

NPI number 1912357682
LBN Legal business name Jackson, Ikishia N
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2016
Last updated Jul 27th, 2021 - about 5 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 1912357682 NPPES
Pennsylvania MEDICAID 103310350-001

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