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Contact Information

COURTNEY JACKSON
231 TREETOP DR # 301
FAYETTEVILLE, NC28311-0606
 Phone: 951-870-5501
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Environmental Modification

224ZE0001X
Indicates primary specialty

NPI Profile & details for COURTNEY JACKSON · (Female)

NPI Number 1043925258
Status Active
Credentials
Entity Individual
Enumeration date 01/23/2023
Last updated 01/23/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 13569
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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