Jackson, Shanna Shaneen

Jackson, Shanna Shaneen is an individual health care provider with primary practice located at 24060 Fir Ave Ste A , Moreno Valley CA 92553-2895. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Jackson, Shanna Shaneen can be contacted via phone (951) 247-8005.

Contact Information

Primary practice address
24060 Fir Ave Ste A Moreno Valley CA 92553-2895
Phone: (951) 247-8005
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 755399 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95013739 California

Profile Details

NPI number 1710506472
LBN Legal business name Jackson, Shanna Shaneen
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2020
Last updated Apr 26th, 2022 - about 4 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.

Request for update

Popular Providers