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DANA A JACKSON PA-C
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1235692112
Individual Registrant: DANA A JACKSON PA-C
Gender: F
Not Sole Proprietor
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: --
Tel: 620-723-3341 Fax: --
Contact information for business:
3801 SW 112TH ST DENTON, NE 68339-3291 US
Tel: 402-770-8575 Fax: --
Tel: 402-770-8575 Fax: --
Registration Information:
NPI: 1235692112
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | NE | 2366 |
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | KS | 15-02445 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
