MRS. KIMBERLY ANN JACKSON (NPI# 1023135126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023135126 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY ANN JACKSON |
| Credential | ARNP |
| Practice Address |
215 E Main St Providence KY 42450-1261 |
| Mailing Address |
Po Box 37 Providence KY 42450-0037 |
| Practice Telephone | 2706677017 |
| Practice Fax Number | 2706679065 |
| Mailing Telephone | 2706677017 |
| Mailing Fax Number | 2706679065 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2018-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
1086349 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100128660 | 05 | |
| KY | MEDICARE - RHCA | K185610 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951394 | Kimberly Sue Jackson | Home Health Aide | 26 W Warner Rd, Coventry Township, OH 44319-1732 | 2020-10-29 |
| 1588278600 | Kimberly Jackson | Counselor | 2703 N Harrison St, Wilmington, DE 19802-2924 | 2020-09-04 |
| 1184244063 | Kimberly Jackson | Music Therapist | 121 Koeppe Dr, Sequim, WA 98382-9489 | 2020-04-21 |
| 1588293278 | Kimberly Dianne Billie Jackson | Nurse Practitioner | 940 Morningside Dr, Sumter, SC 29153-7724 | 2020-04-04 |
| 1710418355 | Kimberly Jackson | Specialist/Technologist | 2402 High Star Dr, Garland, TX 75041-3236 | 2017-03-24 |
| 1386188332 | Kimberly Jackson | Dietitian, Registered | 2318 Longcourt Way Se, Atlanta, GA 30339-0902 | 2016-12-10 |
| 1336682780 | Kimberly Marie Jackson | Nurse Practitioner | 128 Professional Park Dr Unit B, Conway, SC 29526-9260 | 2016-12-02 |
| 1639535719 | Kimberly Renee Jackson | Massage Therapist | 9175 Cypress Waters Blvd Apt 102, Coppell, TX 75019-5068 | 2016-01-05 |
| 1275934887 | Kimberly Jackson | Counselor | 213 Barrett St, Wilmington, DE 19802-2004 | 2014-09-15 |
| 1972930279 | Kimberly Jackson | Nurse's Aide | 4020 Ulmer Rd, 220, Columbia, SC 29209-3305 | 2013-10-01 |
| Street Address |
215 E MAIN ST |
| City | PROVIDENCE |
| State | KY |
| Zip Code | 42450-1261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650662 | Chelsey Aikins | Nurse Practitioner | 215 E Main St, Providence, KY 42450-1261 | 2017-10-13 |
| 1477087963 | Ellen Parrish | Nurse Practitioner | 215 E Main St, Providence, KY 42450-1261 | 2017-04-12 |
| 1427598952 | Allison Marie Choate | Dietitian, Registered | 215 E Main St, Providence, KY 42450-1261 | 2017-03-02 |
| 1407393481 | Ronnah Ann Alexander | Pharmacist | 215 E Main St, Providence, KY 42450-1261 | 2017-01-27 |
| 1740727239 | Joseph Lowery | Nurse Practitioner | 215 E Main St, Providence, KY 42450-1261 | 2017-01-23 |
| 1588013197 | Emma Buchanan | Nurse Practitioner | 215 E Main St, Providence, KY 42450-1261 | 2016-06-06 |
| 1053776005 | Jane Smith | Pharmacist | 215 E Main St, Providence, KY 42450-1261 | 2015-12-17 |
| 1124425418 | Lori R Marrero | Nurse Practitioner | 215 E Main St, Providence, KY 42450-1261 | 2014-12-02 |
| 1205239860 | Jennifer J Collins | Nurse Practitioner | 215 E Main St, Providence, KY 42450-1261 | 2014-09-26 |
| 1790126811 | Cassy L. Chandler | Social Worker | 215 E Main St, Providence, KY 42450-1261 | 2013-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255476594 | Jon Gregory Dunn | Dentist | 110 Barrett St, Providence, KY 42450 | 2007-02-21 |
| 1013010768 | Kentucky Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 105 Us Highway 41a S, Providence, KY 42450 | 2006-09-07 |
| 1871609842 | Wayne C Cole | Family Medicine | 121 East Main St, Providence, KY 42450 | 2006-08-22 |
| 1194020230 | Regional Health Care Affiliates, Inc | Family Medicine | 9086 State Route 132 West, Clay, KY 42450 | 2011-01-21 |
| 1376747519 | Providence Ind. Schools | Local Education Agency (LEA) | 302 W Main St, Providence, KY 42450-1140 | 2007-06-12 |
| 1679670202 | Beth A Devine | Nurse Practitioner | 215 East Main Street, Providence, KY 42450-1261 | 2006-09-17 |
| 1588638969 | Kelly L Cole | Family Medicine | 121 E Main St, Providence, KY 42450-1268 | 2006-02-14 |
| 1578105763 | Amy Michele Hart | Pharmacist | 127 E Main St, Providence, KY 42450-1268 | 2019-10-09 |
| 1043640659 | Christina Cole Chumley | Nurse Practitioner | 121 E Main St, Providence, KY 42450-1268 | 2013-11-18 |
| 1043556491 | Kayla Jean Kukahiko | Physical Therapist | 123 E Main St, Providence, KY 42450-1268 | 2012-12-12 |
| Find all providers in zip 42450 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558840942 | Kathleen Rose Markiewicz | Nurse Practitioner | 325 Plain Street, Suite 401, Providence, RI 02905-2401 | 2018-08-07 |
| 1013037886 | Angela C Thompson | Nurse Practitioner | 169 N Gateway Dr Ste 235, Providence, UT 84332-9803 | 2007-03-29 |
| 1093369936 | Jacalyn Sue Finerty | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2499 | 2019-07-29 |
| 1134699812 | Rachel A Eaton | Nurse Practitioner | 1 Cunningham Sq, Providence, RI 02918-7001 | 2018-11-26 |
| 1164991907 | Gabrielle Marie Kovarie | Nurse Practitioner | 1 Blackstone Pl, Providence, RI 02903-4942 | 2018-11-23 |
| 1467974873 | Jessica L Wood | Nurse Practitioner | 101 Dudley Street, Wih Triage/ldr, Providence, RI 02905-2401 | 2017-07-07 |
| 1912438581 | Ariana Ann Saccoccio | Nurse Practitioner | 1 Blackstone Street, 2nd Floor, Providence, RI 02903 | 2017-03-24 |
| 1790231736 | Mary Beth Dromgoole | Nurse Practitioner | 593 Eddy St, Jane Brown 2 South, Providence, RI 02903-4923 | 2016-08-30 |
| 1538519673 | Veronica Marquis | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2016-06-20 |
| 1669804712 | Paige Mccann | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2013-07-31 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 42450 |
Please comment or provide details below to improve the information on MRS. KIMBERLY ANN JACKSON.
| 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.