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DANA A JACKSON PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1235692112

Individual Registrant:
 DANA A JACKSON PA-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
721 W KANSAS AVE  GREENSBURG, KS 67054-1602 US
Tel: 620-723-3341  Fax: --

Contact information for business:
3801 SW 112TH ST  DENTON, NE 68339-3291 US
Tel: 402-770-8575  Fax: --

Registration Information:
NPI: 1235692112
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
NE2366
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
KS15-02445

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS KS - Page 1



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