MADDILYN LUELLA JACKSON


Address: 9000 Brooktree Rd Ste 200, Wexford, PA 15090-9288
Phone: 7249331320

MADDILYN LUELLA JACKSON (NPI# 1790314946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790314946
Entity Type Individual
Full Name MADDILYN LUELLA JACKSON
Credential PA-C
Practice Address 9000 Brooktree Rd Ste 200
Wexford
PA 15090-9288
Practice Telephone 7249331320
Mailing Telephone 7249331320
Enumeration Date 2020-04-08
Last Update Date 2020-10-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
MA061384 PA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 9000 BROOKTREE RD STE 200
City WEXFORD
State PA
Zip Code 15090-9288

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194142059 Megan Sue Carrigan Dermatology 9000 Brooktree Rd Ste 200, Wexford, PA 15090-9288 2014-03-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932746443 Lauren Jennifer Kinder Nurse Practitioner 103 North Meadows Dr., Suite 220, Wexford, PA 15090 2019-12-03
1235608365 Pittsburgh Ear LLC Audiologist 6041 Wallace Road Ext, Suite 110, Wexford, PA 15090 2018-11-19
1659847739 Anna Zenkova Physician Assistant 10466 Perry Highway, Baierl Honda Cpo Building. 2nd Floor., Wexford, PA 15090 2018-10-16
1831674571 Comprehensive Care Multi-specialty Physician Organization PC Internal Medicine 6400 Brooktree Court., Suite. 320, Wexford, PA 15090 2018-09-28
1760989115 Kerry L Vaughn Nurse Practitioner 12311 Perry Hwy Fl 1, Wexford, PA 15090 2018-04-11
1821446097 John Richard Moesch Internal Medicine 9000 Brooktree Rd, Brooktree Office Park, Suite 2000, Hexford, PA 15090 2016-05-28
1336595511 Kelly Mea Occupational Therapist 10475 Perry Hwy Ste 106g, Wexford, PA 15090 2016-05-06
1194194282 Natassia Dickey Counselor 101 N Meadows Dr Ste 234, Wexford, PA 15090 2015-09-18
1912382631 Jessica Hamilton Dietitian, Registered 155 Towne Centre Avenue, Wexford, PA 15090 2015-07-23
1205211224 Tamara Domnitz Optometrist 110 Vip Dr Ste 301, Wexford, PA 15090 2015-07-21
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710525258 Caroline Anne O'neil Physician Assistant 10431 Perry Hwy Ste 300, Wexford, PA 15090-9200 2019-12-16
1659847739 Anna Zenkova Physician Assistant 10466 Perry Highway, Baierl Honda Cpo Building. 2nd Floor., Wexford, PA 15090 2018-10-16
1285932228 Kristin A Smith Physician Assistant 900 Brooktree Rd, Suite 200, Wexford, PA 15090-9255 2011-02-28
1811203300 Kari Michelle Jones Physician Assistant 1500 Village Run Rd Ste 300, Wexford, PA 15090 2010-08-23
1467786129 Rebecca A. Torquato Physician Assistant 103 Bradford Road, Suite 220 Stonewood Commons II, Wexford, PA 15090 2009-09-29
1558436774 Tiffany D. Pellathy Physician Assistant 3000 Village Run Rd, Bldg. 103-202, Wexford, PA 15090-6315 2006-11-22
1295731693 Nicole M Bowan Physician Assistant 5500 Brooktree Rd, Ste 201, Wexford, PA 15090-9260 2005-06-22
1841839339 Kristen Jackson Physician Assistant 6001 Stonewood Dr, Wexford, PA 15090-7380 2019-12-31
1003457490 Victoria Ryan Physician Assistant 7000 Stonewood Dr Ste 151, Wexford, PA 15090-7376 2019-10-07
1972021210 Rebecca D Heim Physician Assistant 7000 Stonewood Dr Ste 151, Wexford, PA 15090-7376 2017-09-07
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Competitor

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City WEXFORD
Zip Code 15090

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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