Phyllis E Jackson PA-C

NPI 1043649627 - Physician Assistant - 363A00000X

NPI Details
NPI 1043649627
Gender Female
Enumeration Date 11/05/2013
Last Updated 05/06/2014
Entity Type Individual
Active Over 3 years ago
Practice Location
300 EVERGREEN DR
SUITE 150
GLEN MILLS PA, 19342-1059, US
Phone (610) 874-1184
Fax (610) 874-4258
Business Location
300 EVERGREEN DR
SUITE 150
GLEN MILLS PA, 19342-1059, US
Phone (610) 874-1184
Fax (610) 874-4258
Toxanomy
Taxonomy Code 363A00000X
License State Pennsylvania
License Number MA000510L
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According to our database, Ms. Phyllis E Jackson PA-C NPI is 1043649627, taxonomy code is 363A00000X and license number is MA000510L, license state is located at Pennsylvania. Phyllis E Jackson PA-C physically located at 300 Evergreen Dr, Glen Mills PA, 19342-1059. NPI Number Phyllis E Jackson PA-C has the Individual type.

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1043649627 NPI number is provided on an as is basis without warranty of any kind. 1043649627 is maintained by the National Plan & Provider Enumeration System. The contents of Phyllis E Jackson PA-C are for informational purposes only.