Cheryl Jackson, PA
Physician Assistant in Jacksonville, FL. Individual provider (NPI-1).
NPI number1194787630
StatusActive
Last updated in NPPESAug 28, 2020
Details
- NPI
- 1194787630
- Entity type
- Individual (NPI-1)
- Name
- Cheryl Jackson
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2006
- Certification date
- Aug 28, 2020
- Last updated
- Aug 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9101299 | FL | Yes |
Practice location
4500 San Pablo Rd SJacksonville, FL 32224-1865
Phone 904-953-2000
Mailing address
4500 San Pablo Rd SJacksonville, FL 32224-1865
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