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Contact Information

SHAYLA JACKSON, PA-C
6998 CRIDER RD
MARS, PA16046
 Phone: 724-778-3627
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SHAYLA JACKSON · (Female)

NPI # 1679824064
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/25/2012
Last updated 05/19/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 085-011019
  • PA License # MA055773
  • WI Medicaid 100316099
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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