Individual provider · Type 1 NPI

Jackson Alexander Brussseaux

Student in an Organized Health Care Education/Training Program · Chandler, AZ

NPI number 1861344657 Active

Practice location

13507 E Boston St
Chandler, AZ 85225-6079

Call (602) 377-9728 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1861344657

Jackson Alexander Brussseaux's National Provider Identifier is 1861344657, issued on Feb 12, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chandler, AZ. The record was last updated on Feb 12, 2026.