Jackson-Malina, Judith

Jackson-Malina, Judith is an individual health care provider with primary practice located at 221 13Th Avenue Pl Nw Suite 202, Hickory NC 28601-2596. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jackson-Malina, Judith can be contacted via phone (828) 322-8484.

Contact Information

Primary practice address
221 13Th Avenue Pl Nw Suite 202 Hickory NC 28601-2596
Phone: (828) 322-8484
Fax: (828) 324-9526
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201438 North Carolina

Profile Details

NPI number 1154392306
LBN Legal business name Jackson-Malina, Judith
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Oct 9th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1154392306 NPPES
North Carolina MEDICAID 7003530

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