Jackson, Nannie
Jackson, Nannie is an individual health care provider with primary practice located at 9201 N 5Th St , Phoenix AZ 85020-2532. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Jackson, Nannie can be contacted via phone (602) 331-5792.Contact Information
Primary practice address
9201 N 5Th St
Phoenix AZ 85020-2532
Phone: (602) 331-5792
Fax: (602) 331-7855
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LISAC 11861 | Arizona |
Profile Details
| NPI number | 1467823435 |
|---|---|
| LBN Legal business name | Jackson, Nannie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 15th, 2015 |
| Last updated | Oct 15th, 2015 - about 11 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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