Individual provider · Type 1 NPI
Sara Jackson
Medical Physician Assistant · Petersburg, VA
NPI number
1295123602
Active
Practice location
200 Medical Park Blvd
Petersburg, VA 23805-9274
Mailing address
3264 Advance Mills Rd
Ruckersville, VA 22968-3209
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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About NPI 1295123602
Sara Jackson's National Provider Identifier is 1295123602, issued on Jan 7, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Petersburg, VA. The record was last updated on Jan 7, 2015.