NANNIE JACKSON (NPI# 1467823435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467823435 |
| Entity Type | Individual |
| Full Name | NANNIE JACKSON |
| Practice Address |
9201 N 5th St Phoenix AZ 85020-2532 |
| Mailing Address |
2500 W Utopia Rd Suite 100 Phoenix AZ 85027-4171 |
| Practice Telephone | 6023315792 |
| Practice Fax Number | 6023317855 |
| Mailing Telephone | 6234346200 |
| Mailing Fax Number | 6234346164 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC 11861 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
9201 N 5TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85020-2532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538250535 | Desert Mission Inc | Clinic/Center | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2006-09-27 |
| 1811517816 | Aline Catherine Kraus | Student in an Organized Health Care Education/Training Program | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2020-04-20 |
| 1770103848 | Ramy El Mankabady | Student in an Organized Health Care Education/Training Program | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2020-04-19 |
| 1508491119 | Nicole Vaudrin | Dietitian, Registered | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2020-03-04 |
| 1942854393 | Nicole Zahri | Counselor | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2019-07-24 |
| 1225692676 | Pedram Motamedi | Student in an Organized Health Care Education/Training Program | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2019-04-30 |
| 1588125397 | Nathan Mcclane | Student in an Organized Health Care Education/Training Program | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2019-03-26 |
| 1033644810 | Adriana Guadalupe Cardona | Social Worker | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2017-04-28 |
| 1215309919 | Alicia Ottmann | Physician Assistant | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2015-10-21 |
| 1326417684 | Veronica Terez Hurd | Nurse Practitioner | 9201 N 5th St, Phoenix, AZ 85020-2532 | 2015-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683537 | Joseph A Jones | Pharmacist | 7543 N 20th St, Phoenix, AZ 85020 | 2019-05-01 |
| 1871022210 | Amber L Enright | Physical Therapist | 1675 E Morten Ave, 4155, Phoenix, AZ 85020 | 2017-06-08 |
| 1518407683 | Harmony Dental Partners, LLC | Dentist | 7150 North 7th Street, Phoenix, AZ 85020 | 2017-03-08 |
| 1104369495 | Michelle Mastro | Registered Nurse | 1234 E. Northern Avenue, Phoenix, AZ 85020 | 2016-11-18 |
| 1912363003 | Charles D. Atkinson | Social Worker | 1716 East Seldon Lane, Phoenix, AZ 85020 | 2016-01-06 |
| 1477928471 | Erin Testa | Psychologist | 7600 N 16th St Ste 218, Phoenix, AZ 85020 | 2015-12-02 |
| 1972977569 | Borpan Monitoring, Pllc | Psychiatry & Neurology | 7000 N 16th Street Ste 120 # 281, Phoenix, AZ 85020 | 2015-11-19 |
| 1275906984 | Summer Macey | Nurse Practitioner | 9225 N. 3rd St #304, Affiliated Hospitalists, Phoenix, AZ 85020 | 2015-11-03 |
| 1356712772 | Maurie S Comenzo | Clinic/Center | 11024 North 28th Drive/suite #200, Lake Biltmore Corporate Center, Phoenix, AZ 85020 | 2015-10-12 |
| 1700260692 | Stansberry Family Dentistry Pllc | Dentist | 7501 N. 16th St. #100, Phoenix, AZ 85020 | 2015-07-10 |
| Find all providers in zip 85020 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885716 | Global Family LLC | Counselor | 4523 N 92nd Ave, Phoenix, AZ 85037-2450 | 2020-09-15 |
| 1982218772 | Bashar Aldeen | Counselor | 3401 W Country Gables Dr, Phoenix, AZ 85053-4756 | 2020-08-31 |
| 1508478082 | Tahonna Latreise Surrell | Counselor | 3236 E Chandler Blvd Unit 1034, Phoenix, AZ 85048-7281 | 2020-08-17 |
| 1346858883 | Heather Romero | Counselor | 110 W Camelback Rd Ste 200, Phoenix, AZ 85013-2564 | 2020-07-21 |
| 1134747546 | Arcadian Homes, LLC | Counselor | 5924 W Trumbull Rd, Phoenix, AZ 85043-1967 | 2020-07-13 |
| 1902423023 | Danielle Jeanette Le Blanc | Counselor | 3228 W Silver Sage Ln, Phoenix, AZ 85083-5866 | 2020-07-06 |
| 1366060477 | Rising Phoenix Neighborhood | Counselor | 202 E Earll Dr Unit 360-35, Phoenix, AZ 85012-2634 | 2020-07-06 |
| 1043832504 | Candice Marie Isaacson | Counselor | 2911 W Sunnyside Dr, Phoenix, AZ 85029-3302 | 2020-05-07 |
| 1639799356 | Harbor Health | Counselor | 3213 S 66th Ave, Phoenix, AZ 85043-1922 | 2020-04-22 |
| 1083247357 | Edward Scott White | Counselor | 2150 E Bell Rd Unit 1042, Phoenix, AZ 85022-2973 | 2020-02-14 |
| Find all providers in PHOENIX | ||||
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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.