Thomas-Jackson, Wilhelmina G

Thomas-Jackson, Wilhelmina G is an individual health care provider with primary practice located at 226 Mill Hill Ave 3Rd Floor, Bridgeport CT 06610-2811. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Thomas-Jackson, Wilhelmina G can be contacted via phone (203) 384-3873.

Contact Information

Primary practice address
226 Mill Hill Ave 3Rd Floor Bridgeport CT 06610-2811
Phone: (203) 384-3873
Fax: (203) 384-3829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 000127 Connecticut

Profile Details

NPI number 1366406662
LBN Legal business name Thomas-Jackson, Wilhelmina G
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Aug 24th, 2016 - about 10 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 1366406662 NPPES
Connecticut MEDICAID 004221066

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