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Contact Information

SHIRLEY J JACKSON, RN
21 NORTH ATWOOD AVE
JANESVILLE, WI53648
 Phone: 608-931-4477
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

163WH0200X
Indicates primary specialty

NPI Profile & details for SHIRLEY J JACKSON · (Female)

NPI # 1538218292
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 01/10/2007
Last updated 03/19/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • WI Medicaid 39916200
Hospital affiliation(s) Not Available
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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