Jayly Jermayne Jackson, is a
Community Health Worker based in Anchorage, Alaska. Jayly Jermayne Jackson is licensed to practice in * (Not Available) (license number ) and his current practice location is
3801 University Lake Dr Ste 205, Anchorage, Alaska. He can be reached at his office (for appointments etc.) via phone at
(907) 729-2492.
NPI number for Jayly Jermayne Jackson is 1114698818 and his current mailing address is 3801 University Lake Dr, Anchorage, Alaska. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114698818.
Healthcare Provider's Profile
| Full Name | Jayly Jermayne Jackson |
|---|
| Gender | Male |
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| Speciality | Community Health Worker |
|---|
| Location | 3801 University Lake Dr Ste 205, Anchorage, Alaska |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1114698818
- Provider Enumeration Date: 09/22/2021
- Last Update Date: 01/31/2023
Medical Identifiers
Medical identifiers for Jayly Jermayne Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114698818 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jayly Jermayne Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jayly Jermayne Jackson,
3801 University Lake Dr,
Anchorage, AK 99508-4658
Ph: (907) 729-2492 | Jayly Jermayne Jackson,
3801 University Lake Dr Ste 205,
Anchorage, AK 99508-4658
Ph: (907) 729-2492 |
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