National Provider Identifier
Seolar L Jackson, PMNP-BC
Seolar L Jackson, PMNP-BC is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 882-3151.
Profile Overview
- NPI
- 1043698384
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Enumeration Date
- May 07, 2015
- Last Updated
- November 09, 2022
Practice Location
- 768 Delaware Ave
- Buffalo, NY 14209-2006
Phone: (716) 882-3151
Mailing Address
- 2605 Sweet Home RD
- Amherst, NY 14228-2129
Specialties
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1043698384
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Seolar
- Middle Name
- L
- Credential
- PMNP-BC
- Mailing Street Address
- 2605 Sweet Home RD
- Mailing City
- Amherst
- Mailing State
- NY
- Mailing ZIP Code
- 14228-2129
- Mailing Country
- US
- Mailing Phone
- (716) 444-8635
- Practice Street Address
- 768 Delaware Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14209-2006
- Practice Country
- US
- Practice Phone
- (716) 882-3151
- Practice Fax
- (716) 886-4002
- Enumeration Date
- May 07, 2015
- Last Updated
- November 09, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 09, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X), Registered Nurse (163W00000X)