Individual
EMMA CAROL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
415 S LANDMARK AVE, BLOOMINGTON, IN 47403-5003
(812) 333-7433
(812) 333-7435
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10005272A
IN
363A00000X
Physician Assistant
Primary
—
IN
Other
Enumeration date
03/16/2026
Last updated
04/06/2026
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