Jackson, Kory

Jackson, Kory is an individual health care provider with primary practice located at 13685 Doctors Way Ste 170 , Fort Myers FL 33912-4337. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Jackson, Kory can be contacted via phone (239) 343-0629.

Contact Information

Primary practice address
13685 Doctors Way Ste 170 Fort Myers FL 33912-4337
Phone: (239) 343-0629
Fax: (239) 343-0625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 209014384 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X APRN11024568 Florida

Profile Details

NPI number 1669823068
LBN Legal business name Jackson, Kory
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2016
Last updated Jul 14th, 2023 - about 3 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 1669823068 NPPES
Florida MEDICAID 118448900

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