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Contact Information

KIM J JACKSON
1135 EAST 82ND STREET
BROOKLYN, NY11236
 Phone: 347-525-3112
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
 

Nursing Care

251J00000X
Indicates primary specialty

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

NPI # 1285944637
Status Active
Credentials
Entity Individual
Enumeration date 10/19/2010
Last updated 10/19/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 302935-1
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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