SIMONE JACKSON (NPI# 1134644396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134644396 |
| Entity Type | Individual |
| Full Name | SIMONE JACKSON |
| Other Name | SIMONE JACKSON |
| Credential | FNP |
| Practice Address |
9029 S Pecos Rd Ste 2800 Henderson NV 89074-7199 |
| Mailing Address |
5250 Stewart Ave Apt 2009 Las Vegas NV 89110-3645 |
| Practice Telephone | 9012831975 |
| Practice Fax Number | 9012831975 |
| Mailing Telephone | 9012831975 |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2018-04-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN002716 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP134295 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9029 S Pecos Rd Ste 2800, Henderson, NV 890747199 | 9012831975 | 9012831975 |
| 8200 Walnut Hill Ln Apt 1142, Dallas, TX 752314426 | 9012831975 | 9012831975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740846328 | Simone Jackson | Physical Therapist | 70 Pleasant Hill Ln, Tamarac, FL 33319-2442 | 2019-05-19 |
| 1619483013 | Simone Jackson | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2017-12-20 |
| 1871041657 | Simone D Jackson | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2016-09-21 |
| 1437519394 | Simone Jackson | Social Worker | 3491 Gandy Blvd N, #201, Pinellas Park, FL 33781-2658 | 2016-03-03 |
| 1205214988 | Simone Rene Jackson | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-05-13 |
| Street Address |
9029 S PECOS RD STE 2800 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074-7199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639659865 | Celes Chang | Nurse Practitioner | 9029 S Pecos Rd Ste 2800, Henderson, NV 89074-7199 | 2018-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083227870 | Raven Nicole Pirtle | Nurse Practitioner | 1245 Glenshiel Dr, Henderson, KY 42420-2529 | 2020-08-31 |
| 1811509359 | Kristi Lynn Navarette | Nurse Practitioner | 3058 Hushed Sonnet Ave, Henderson, NV 89044-0558 | 2020-08-17 |
| 1275143711 | Kristyn Cisilino | Nurse Practitioner | 2556 Chateau Clermont St, Henderson, NV 89044-0459 | 2020-08-07 |
| 1972113363 | Rini Susan Mathews | Nurse Practitioner | 3396 Dalmore St, Henderson, NV 89044-1722 | 2020-07-31 |
| 1033735014 | Savinder Kaur Virk | Nurse Practitioner | 10747 Shasta Glow Ct, Henderson, NV 89052-8691 | 2020-06-24 |
| 1811517022 | D Ana Curtis | Nurse Practitioner | 815 Chameleon Star Ave, Henderson, NV 89015-2411 | 2020-04-17 |
| 1275169013 | Joyce Carlos Damiano | Nurse Practitioner | 2839 Saint Rose Pkwy Ste 130, Henderson, NV 89052-4849 | 2020-03-12 |
| 1568008878 | Oliver Torrefranca | Nurse Practitioner | 910 Monte Etna Ave, Henderson, NV 89012-2654 | 2019-11-21 |
| 1568006864 | Melissa Ann Ridella | Nurse Practitioner | 1748 W Horizon Ridge Pkwy, Henderson, NV 89012-4833 | 2019-10-30 |
| 1245881317 | Edith Borgert | Nurse Practitioner | 3039 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-4193 | 2019-09-20 |
| Find all providers in HENDERSON | ||||
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| 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.