Princiotta, Jonathan
Princiotta, Jonathan is an individual health care provider with primary practice located at 2500 N State St 2500 North State Street, Jackson MS 39216-4500. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, which is considered as his primary health care specialty. Princiotta, Jonathan can be contacted via phone (601) 815-6960.Contact Information
Primary practice address
2500 N State St 2500 North State Street
Jackson MS 39216-4500
Phone: (601) 815-6960
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care | 363LP0222X | 901958 | Mississippi |
Profile Details
| NPI number | 1215476064 |
|---|---|
| LBN Legal business name | Princiotta, Jonathan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2017 |
| Last updated | Apr 5th, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215476064 | NPPES |
| Mississippi | MEDICAID | 05103351 |
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