Jackson, Yolanda H.

Jackson, Yolanda H. is an sole proprietor health care provider with primary practice located at 512 Thomas St. , Boyle MS 38730. She recently has only one registered license in Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization, which is considered as her primary health care specialty. Jackson, Yolanda H. can be contacted via phone (662) 545-4867.

Contact Information

Primary practice address
512 Thomas St. Boyle MS 38730
Phone: (662) 545-4867
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X Mississippi

Profile Details

NPI number 1740626290
LBN Legal business name Jackson, Yolanda H.
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2013
Last updated May 10th, 2013 - about 13 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 1740626290 NPPES
Mississippi MEDICAID 38730

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