Jackson, Regula R.

Jackson, Regula R. is an individual health care provider with primary practice located at 4212 North 16Th Street , Phoenix AZ 85016-5319. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Jackson, Regula R. can be contacted via phone (602) 263-1511.

Contact Information

Primary practice address
4212 North 16Th Street Phoenix AZ 85016-5319
Phone: (602) 263-1511
Fax: (602) 263-1637
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X RN057918 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN057918 Arizona

Profile Details

NPI number 1891880100
LBN Legal business name Jackson, Regula R.
Credentials CNM, OB-GYN NP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Aug 23rd, 2011 - about 15 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 1891880100 NPPES
Arizona MEDICAID 451667
Arizona Other AZ0145750

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