| Doctor Name: | MS. ANN PATRICIA JACKSON |
| NPI Number: | 1114101896 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | 4131 |
| Business Practice Address: | 200 Elkin Business Park Dr Elkin, NC - 286213159 |
| Business Phone Number: | 3368351000 |
| Business Fax Number: | 3368351075 |
| Mailing Address: | 200 Elkin Business Park Dr, ELKIN |
| State: | NC |
| Postal Code: | 286213159 |
| Phone Number: | 3368351000 |
| Fax Number: | 3368351075 |
| NPI Enumeration Date: | 12/18/2007 |
| NPI Last Update Date: | 12/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 4131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |