Mrs. Angela Jackson
Prosthetist
2164 Bonnie Ln
Waldorf
, Maryland 20601-3902
Mrs. Angela Jackson
Prosthetist
2164 Bonnie Ln
Waldorf
, Maryland 20601-3902
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About
Features
Specialties
- Prosthetist
Languages spoken
- English
Location
First Address
- Mrs. Angela Jackson
- Po Box 2252
- Waldorf, MD
- Zip : 20604-2252
- Phone :
Second Address
- Mrs. Angela Jackson
- 2164 Bonnie Ln
- Waldorf, MD
- Zip : 20601-3902
- Phone : (202) 748-1632
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224P00000X | Prosthetist |
National Provider Identifier
| NPI | 1336742469 |
|---|---|
| Provider Name | Mrs. Angela Jackson |
| First Address | Waldorf, MD 20604-2252 |
| Second Address | Waldorf, MD 20601-3902 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/11/2020 |
| Last Update Date | 20/11/2020 |
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.