National Provider Identifier Database

GLENDA L JACKSON, NP – NPI #1134208119
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

GLENDA L JACKSON, NP
117 W LIBERTY STREET
ROME, NY13440
Phone: 315-339-0401
Fax: 315-339-2957
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for GLENDA L JACKSON

NPI Number 1134208119
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 11/02/2006
Last updated 03/19/2013 - About 13 years ago
Sole proprietor1 No
Identifiers
  • NY License #: F3340511
  • NY Medicaid: 03353028
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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