Jackson, Stephanie Perry

Jackson, Stephanie Perry is an individual health care provider with primary practice located at 162 Feather Ln Suite E, Canton MS 39046-8510. 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, Stephanie Perry can be contacted via phone (601) 859-0140.

Contact Information

Primary practice address
162 Feather Ln Suite E Canton MS 39046-8510
Phone: (601) 859-0140
Fax: (601) 510-9643
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R862558 Mississippi

Profile Details

NPI number 1821097858
LBN Legal business name Jackson, Stephanie Perry
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Oct 20th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1821097858 NPPES
Mississippi MEDICAID 00780035

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