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Individual
KIERNEY ELIZABETH JACKSON
Active
Individual
KIERNEY ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02288
NC
363A00000X
Physician Assistant
1397
SC
363A00000X
Physician Assistant
Primary
7782
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0949PA
—
SC
05
—
1003057621
—
NC
Enumeration date
03/11/2009
Last updated
09/25/2025
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