Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CARLY ANNE JACKSON, PA-C
ActiveCARLY ANNE JACKSON, PA-C is a Physician Assistant healthcare provider located in ROCKFORD, Illinois. NPI 1053696971 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ROCKFORD, IL
Registration Details
- NPI Number
- 1053696971
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 12, 2011 (14.827557217602 yrs)
- Last Updated
- Jun 5, 2014
Practice Information
- Address
-
324 ROXBURY RDROCKFORD, IL, 611075090Browse IL providers · Browse ZIP 61107
- Phone
- 8153989491
- Fax
- 8153817333
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in ROCKFORD, IL
| Name | Credential | NPI |
|---|---|---|
| MS. AMY L DINELLO | PA-C | 1972595296 |
| MR. MATTHEW DAVID SCHWABERO | PA-C | 1912989195 |
| MR. SEAN CRESTON SOARE | PA-C | 1548242738 |
| MR. GREGORY LEE CAMPBELL | PA-C | 1508849480 |
| GORDON EGGERS | — | 1033192927 |
| MR. THOMAS S HANS JR. | PA-C | 1750369914 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.