Jackson, Marylee

Jackson, Marylee is an individual health care provider with primary practice located at 3 Saint Francis Dr Ste 360 , Greenville SC 29601-3972. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Jackson, Marylee can be contacted via phone (864) 232-4349.

Contact Information

Primary practice address
3 Saint Francis Dr Ste 360 Greenville SC 29601-3972
Phone: (864) 232-4349
Fax: (864) 233-8103
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 8826 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 509 South Carolina

Profile Details

NPI number 1215978044
LBN Legal business name Jackson, Marylee
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Apr 1st, 2016 - about 10 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 1215978044 NPPES
South Carolina MEDICAID 0037PA
South Carolina MEDICAID 3337PA

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