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Contact Information

ANITA J JACKSON
680 S 4TH ST
LOUISVILLE, KY40202-2407
 Phone: 800-996-7566
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

163WR0400X
Indicates primary specialty

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

NPI # 1992125199
Status Active
Credentials
Entity Individual
Enumeration date 04/26/2014
Last updated 04/26/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2014008537
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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