Provider Demographics
NPI:1669022570
Name:JACKSON MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:JACKSON MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:HENSLEY
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:828-339-2273
Mailing Address - Street 1:1188 SKYLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-8002
Mailing Address - Country:US
Mailing Address - Phone:828-339-2273
Mailing Address - Fax:828-339-2274
Practice Address - Street 1:1188 SKYLAND DRIVE
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-8002
Practice Address - Country:US
Practice Address - Phone:828-339-2273
Practice Address - Fax:828-339-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty