AMANDA JACKSON (NPI# 1205460045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205460045 |
| Entity Type | Individual |
| Full Name | AMANDA JACKSON |
| Credential | CPNP |
| Practice Address |
940 W Mount Vernon St Ste 220 Nixa MO 65714-9613 |
| Practice Telephone | 4177245437 |
| Mailing Telephone | 4177245437 |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 2011022742 | MO | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
2020008008 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669008397 | Amanda Jackson | Pharmacist | 1418a W Main St Ste A, Lebanon, TN 37087-3114 | 2020-03-13 |
| 1730692765 | Amanda Lyn Jackson | Occupational Therapist | 2222 S Rockport Rd, Boonville, IN 47601-7926 | 2017-11-13 |
| 1982143467 | Amanda Jackson | Occupational Therapist | 5305 Reserve Dr Ne, Brookhaven, GA 30319-5924 | 2017-02-17 |
| 1528309473 | Amanda Nicole Jackson | Licensed Practical Nurse | 923 Cottage Ave, Miamisburg, OH 45342-1805 | 2013-03-01 |
| 1013254887 | Amanda Meister Jackson | Pharmacist | 10358 Riverside Dr Ste 140, Palm Beach Gardens, FL 33410-4203 | 2013-01-13 |
| 1285905240 | Amanda Jackson | Occupational Therapist | 1760 Turning Leaf Trl, Haughton, LA 71037-9531 | 2012-01-23 |
| 1245368661 | Amanda L Jackson | Physical Therapist | 17 Carlton Rd, Hutchinson, KS 67502-4423 | 2007-02-28 |
| 1861452112 | Amanda Elizabeth Jackson | Occupational Therapist | 121 Cox St, Benton, AR 72015-4611 | 2006-03-23 |
| 1437763638 | Amanda Jackson | Pharmacist | 7301 Theodore Dawes Rd, Theodore, AL 36582-4029 | 2020-09-04 |
| 1629609748 | Amanda Jackson | Community Health Worker | 401 Tuscarawas St W Ste 501, Canton, OH 44702-2045 | 2020-01-28 |
| Street Address |
940 W MOUNT VERNON ST STE 220 |
| City | NIXA |
| State | MO |
| Zip Code | 65714-9613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932396777 | Kody Blake Finstad | Pediatrics | 940 W Mount Vernon St Ste 220, Nixa, MO 65714 | 2007-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895440 | Lester E Cox Medical Centers | Clinic/Center | 501 N Old Wilderness Road, Nixa, MO 65714 | 2020-09-10 |
| 1568941144 | Smith Management Services, LLC | Durable Medical Equipment & Medical Supplies | 105 S Ridgecrest Ave Ste 2, Nixa, MO 65714 | 2018-08-14 |
| 1942706692 | Phillip Marshal Guison | Chiropractor | 696 W Mount Vernon St, Nixa, MO 65714 | 2018-04-02 |
| 1831561554 | Gray Psychological Services LLC | Psychologist | 402 B W. Mt. Vernon Street, Ste 337, Nixa, MO 65714 | 2015-10-21 |
| 1053787317 | Nicole Blanchard | Speech-Language Pathologist | 1801 Quail Ln, Nixa, MO 65714 | 2015-08-20 |
| 1629410766 | Danielle Ranae Lee | Nurse Practitioner | 940 W Mount Vernon St Ste 210, Nixa, MO 65714 | 2013-07-17 |
| 1205197373 | Kelly Dove Dove | Dentist | 725 W Mt. Vernon St., Nixa, MO 65714 | 2012-06-05 |
| 1831473818 | Amy Susan Wells | Pharmacist | 106 N Massey, Nixa, MO 65714 | 2011-10-07 |
| 1013207612 | Ashley E Pritchett | Counselor | 402b Mt Vernon, #122, Nixa, MO 65714 | 2011-04-15 |
| 1760632400 | Jennifer Lynn Maloney | Counselor | 611a W. Mount Vernon Street, Nixa, MO 65714 | 2008-09-30 |
| Find all providers in zip 65714 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689203390 | Kathleen Rippe Dowd | Nurse Practitioner | 59 Pointer Ln, Saint Louis, MO 63124-2018 | 2020-04-04 |
| 1871126391 | Kelsey Lonergan | Nurse Practitioner | 10915 Three Court Dr, Saint Louis, MO 63123-5959 | 2020-02-13 |
| 1518599778 | Eva Maria Gallina | Nurse Practitioner | 4525 Mid Rivers Mall Dr Ste 110, Saint Peters, MO 63376-2820 | 2020-02-06 |
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1003383324 | Jennifer Marie Jacobi | Nurse Practitioner | 1 Childrens Pl Fl 12, Saint Louis, MO 63110-1002 | 2018-10-24 |
| 1902315609 | Regina Victoria Maloney | Nurse Practitioner | 851 E 5th St Ste 300, Washington, MO 63090-3130 | 2017-09-25 |
| 1093235368 | Sally Williams Ehrich | Nurse Practitioner | 1004 Carondelet Dr Ste 350, Kansas City, MO 64114-4801 | 2017-06-27 |
| 1366995789 | Shawn Danielle Neyens | Nurse Practitioner | 303 N Keene St Ste 404, Columbia, MO 65201-7193 | 2016-08-02 |
| 1114381563 | Kathleen B Shaughnessy | Nurse Practitioner | 9580 Watson Rd, Ste A, Saint Louis, MO 63126-1539 | 2016-04-12 |
| 1518327071 | Lauren Sommero | Nurse Practitioner | 1516 Bridge School Road, Rolla, MO 65401-8115 | 2016-02-26 |
| Find all providers with the same taxonomy | ||||
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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.