Autumn A Jackson, MHS, PA-C
Physician Assistant, Medical in Falls Church, VA. Individual provider (NPI-1).
NPI number1689629099
StatusActive
Last updated in NPPESJul 11, 2011
Details
- NPI
- 1689629099
- Entity type
- Individual (NPI-1)
- Name
- Autumn A Jackson
- Credential
- MHS, PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 23, 2006
- Last updated
- Jul 11, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | C0003077 | MD | Yes |
| 363AM0700X | Physician Assistant, Medical | 0110002073 | VA |
Other names
- Autumn A McKenzie (Former Name)
Practice location
3300 Gallows RdInova Fairfax Ed
Falls Church, VA 22042-3307
Phone 703-776-2690
Mailing address
7832 Tilghman StFulton, MD 20759-2579
Phone 202-276-8671
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All 16 Medical Physician Assistant providers in Falls Church · All 4,923 providers in Falls Church
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