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Contact Information

LAURA P JACKSON, M.S.ED.,ATC, LAT
3300 AIRPORT ROAD
SOUTHERN PINES, NC28387
 Phone: 910-692-6920
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for LAURA P JACKSON · (Female)

NPI # 1497208987
Status Active
Credentials M.S.ED.,ATC, LAT
Entity Individual
Enumeration date 08/01/2016
Last updated 08/01/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # AL3704
  • NY License # 002200
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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