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Contact Information

REGULA R JACKSON, CNM, OB-GYN NP
4212 NORTH 16TH STREET
PHOENIX, AZ85016-5319
 Phone: 602-263-1511
 Fax: 602-263-1637
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
 

Obstetrics & Gynecology

363LX0001X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for REGULA R JACKSON · (Female)

NPI Number 1891880100
Status Active
Credentials CNM, OB-GYN NP
Entity Individual
Enumeration date 10/03/2006
Last updated 08/23/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # RN057918
  • AZ Medicaid 451667
  • AZ Other AZ0145750 BCBS
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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