Jackson, Johnna L

Jackson, Johnna L is an individual health care provider with primary practice located at 1847 Sw Barnett Way , Lake City FL 32025. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Jackson, Johnna L can be contacted via phone (386) 755-2240.

Contact Information

Primary practice address
1847 Sw Barnett Way Lake City FL 32025
Phone: (386) 755-2240
Fax: (386) 755-6598
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2552432 Florida

Profile Details

NPI number 1639179435
LBN Legal business name Jackson, Johnna L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2005
Last updated May 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639179435 NPPES
Florida MEDICAID 301881400

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