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Contact Information

NICOLE JACKOWSKI
100 WILSON ROAD
BENTLEYVILLE, PA15314-1028
 Phone: 724-239-2390
 Fax: 724-239-2393
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Primary Care

363LP2300X 50 Nurse Practitioner
 

School

363LS0200X 50 Nurse Practitioner
 

Women's Health

363LW0102X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for NICOLE JACKOWSKI · (Female)

NPI # 1528576618
Status Active
Credentials
Entity Individual
Enumeration date 01/11/2018
Last updated 03/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • PA License # SP018536
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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