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Contact Information

ANDREA JACKSON
10040 HILLVIEW DR
PENSACOLA, FL32514-5499
 Phone: 850-607-6024
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ANDREA JACKSON · (Female)

NPI # 1598175911
Status Active
Credentials
Entity Individual
Enumeration date 05/07/2014
Last updated 05/07/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PTA 21106
  • FL Medicaid 314000000X
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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