National Provider Identifier
Susan Elaine Jackson, RPA-C
Susan Elaine Jackson, RPA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Lyons, NY and a listed phone number of (315) 946-6075.
Profile Overview
- NPI
- 1649557208
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- November 10, 2011
- Last Updated
- November 10, 2011
Practice Location
- 12 Leach RD
- Lyons, NY 14489-9732
Phone: (315) 946-6075
Specialties
- Medical Physician Assistant (363AM0700X)
Full Record
- NPI
- 1649557208
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Susan
- Middle Name
- Elaine
- Name Prefix
- MS.
- Credential
- RPA-C
- Mailing Street Address
- 12 Leach RD
- Mailing City
- Lyons
- Mailing State
- NY
- Mailing ZIP Code
- 14489-9732
- Mailing Country
- US
- Mailing Phone
- (315) 946-6075
- Practice Street Address
- 12 Leach RD
- Practice City
- Lyons
- Practice State
- NY
- Practice ZIP Code
- 14489-9732
- Practice Country
- US
- Practice Phone
- (315) 946-6075
- Enumeration Date
- November 10, 2011
- Last Updated
- November 10, 2011
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X)