Gloria L Jackson
Nurse Practitioner
900 Medical Center Dr Ste 200
Sewell
, New Jersey 08080-2358
Gloria L Jackson
Nurse Practitioner
900 Medical Center Dr Ste 200
Sewell
, New Jersey 08080-2358
(215) 349-8144
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Gloria L Jackson
- 3400 Civic Center Blvd Pcam 4 West
- Philadelphia, PA
- Zip : 19104
- Fax : (215) 349-8144
- Phone : (215) 615-5858
Second Address
- Gloria L Jackson
- 900 Medical Center Dr Ste 200
- Sewell, NJ
- Zip : 08080-2358
- Phone : (856) 557-7900
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 26NJ00058800 | NJ |
| N | 363L00000X | Nurse Practitioner | SP007231 | PA |
National Provider Identifier
| NPI | 1013035294 |
|---|---|
| Provider Name | Gloria L Jackson |
| First Address | Philadelphia, PA 19104 |
| Second Address | Sewell, NJ 08080-2358 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/03/2007 |
| Last Update Date | 11/12/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.