GLORIA J. JACKSON (NPI# 1245213354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245213354 |
| Entity Type | Individual |
| Full Name | GLORIA J. JACKSON |
| Credential | FNP |
| Practice Address |
9097 Collinsville Rd Collinsville MS 39325-9779 |
| Mailing Address |
Po Box 2106 Meridian MS 39302-2106 |
| Practice Telephone | 6016268874 |
| Practice Fax Number | 6016268592 |
| Mailing Telephone | 6017034282 |
| Mailing Fax Number | 6017034597 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2013-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R715654 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS OF AL | 730-15594 | 01 | |
| MS | 09573377 | 05 | |
| AL | 891010060 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619371507 | Gloria Jackson | Counselor | 800 N. Rainbow Blvd Suite 215, Las Vegas, NV 89107 | 2014-10-21 |
| 1013035294 | Gloria L Jackson | Nurse Practitioner | 900 Medical Center Dr Ste 200, Sewell, NJ 08080-2358 | 2007-03-27 |
| 1205874369 | Gloria Jackson | Social Worker | 220 W Congress St Fl 2, Detroit, MI 48226-3289 | 2006-06-02 |
| 1356789713 | Gloria Jackson | Licensed Practical Nurse | 525 S 9th St, Lindenhurst, NY 11757-4529 | 2013-06-07 |
| 1639421043 | Gloria J. Jackson | Rehabilitation Practitioner | 3095 E Patrick Ln, Suite 12, Las Vegas, NV 89120-4932 | 2012-10-09 |
| 1235123423 | Gloria M Jackson | Family Medicine | 222 Grafton Dr, Grafton, VA 23692-2152 | 2005-09-02 |
| Street Address |
9097 COLLINSVILLE RD |
| City | COLLINSVILLE |
| State | MS |
| Zip Code | 39325-9779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346222890 | Edward Daniel Henderson Jr. | Family Medicine | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2005-11-18 |
| 1689096505 | Wendy D Gressett | Nurse Practitioner | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2014-01-11 |
| 1073959375 | Laird Hospital, Inc | Family Medicine | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2013-05-14 |
| 1104115500 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2011-04-06 |
| 1578796462 | Rush Care, Inc. | Clinic/Center | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2009-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033609409 | Anna Victoria Stewart | Speech-Language Pathologist | 11790 Pine Grove Rd, Collinsville, MS 39325 | 2018-05-11 |
| 1083160782 | Chandra Sumlin-brown Dba Sumlin Behavioral Services | Psychiatric Hospital | 8237b Okatibbee Dam Road, Collinsville, MS 39325 | 2016-09-01 |
| 1982948980 | Lisa Wiliams | Registered Nurse | 8237 A Okatibbee Dam Rd, Collinsville, MS 39325 | 2012-11-15 |
| 1770883688 | Collinsville Family Dental | Dentist | 9171 A, Old Hwy 19n, Collinsville, MS 39325 | 2010-10-26 |
| 1942550280 | Adam Turbyfill | Pharmacist | 9155 Hwy 19, Collinsville, MS 39325-0175 | 2012-09-13 |
| 1811001878 | Collinsville Drugs Inc | Pharmacy | 9158 Hwy 19, Collinsville, MS 39325-0175 | 2006-08-18 |
| 1184238396 | Veronica Necole Mcfadden | Student in an Organized Health Care Education/Training Program | 8583 Wilsondale Rd, Collinsville, MS 39325-8957 | 2020-09-04 |
| 1659688422 | Oya Weston Hampton | Counselor | 9056b Collinsville Rd, Collinsville, MS 39325-9100 | 2010-09-01 |
| 1801997606 | Tammy N Henderson | General Practice | 9325c Highway 19 N, Collinsville, MS 39325-9219 | 2006-09-26 |
| 1477642791 | Kid's Clinic, Pllc | General Practice | 9325c Highway 19 N, Collinsville, MS 39325-9219 | 2006-10-12 |
| Find all providers in zip 39325 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861005878 | Deana Rae Williams | Nurse Practitioner | 306 Denton Ct, Collinsville, TX 76233-9700 | 2020-08-28 |
| 1407493596 | Kristen Thames | Nurse Practitioner | 11115 Hill Thompson Rd, Collinsville, MS 39325-9313 | 2019-12-08 |
| 1396204301 | Kenecia Dones | Nurse Practitioner | 248 Sandridge Dr, Collinsville, IL 62234-3792 | 2019-03-19 |
| 1861960221 | Samantha Rae Jackson | Nurse Practitioner | 320 Sumner Blvd, Collinsville, IL 62234-1929 | 2018-11-05 |
| 1437658523 | Bridget Suzanne Wyatt | Nurse Practitioner | 14311 E 126th St N, Collinsville, OK 74021-4130 | 2018-02-05 |
| 1821513771 | Candace Marie Young | Nurse Practitioner | 247 Ramble Rd, Collinsville, VA 24078-2645 | 2017-08-11 |
| 1467808881 | Brandi Ware | Nurse Practitioner | 52 S Valley Ave Ste B, Collinsville, AL 35961-3263 | 2016-05-05 |
| 1841818010 | Dana Hall Siniard | Nurse Practitioner | 52 S Valley Ave Ste B, Collinsville, AL 35961-3263 | 2020-07-13 |
| 1659917227 | Jan Byerly | Nurse Practitioner | 1205 W Main St, Collinsville, OK 74021-3114 | 2019-11-19 |
| 1689096505 | Wendy D Gressett | Nurse Practitioner | 9097 Collinsville Rd, Collinsville, MS 39325-9779 | 2014-01-11 |
| Find all providers in COLLINSVILLE | ||||
| City | COLLINSVILLE |
| Zip Code | 39325 |
Please comment or provide details below to improve the information on GLORIA J. 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.