TERESA JACKSON (NPI# 1558780478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558780478 |
| Entity Type | Individual |
| Full Name | TERESA JACKSON |
| Credential | CLS, ASCP |
| Practice Address |
4010 S Mulberry St Pine Bluff AR 71603-7000 |
| Practice Telephone | 8705416012 |
| Practice Fax Number | 8705418696 |
| Mailing Telephone | 8705416012 |
| Mailing Fax Number | 8705418696 |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2014-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QM0706X |
Spec/Tech, Pathology Specialization: Medical Technologist |
Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336485390 | Teresa Jackson | Rehabilitation Practitioner | 2244 Revere St, North Las Vegas, NV 89030-4011 | 2012-12-19 |
| 1972865442 | Teresa Alice Jackson | Contractor | 41 Green St, Valley Stream, NY 11580-4815 | 2012-06-11 |
| 1477881696 | Teresa Danielle Jackson | Chiropractor | 5304 Panola Industrial Blvd Ste E, Decatur, GA 30035-4065 | 2009-11-29 |
| 1831317528 | Teresa B. Jackson | Pharmacist | Lower Level Reynolds Gym Wingate Road, Lower Level Reynolds Gym Wingate Road, Winston-salem, NC 27109 | 2007-04-20 |
| 1700982444 | Teresa L Jackson | Family Medicine | 17880 147th St Se, Monroe, WA 98272-1014 | 2006-09-16 |
| 1649744343 | Teresa M Jackson | Counselor | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2019-01-15 |
| 1306372842 | Teresa Lynne Jackson | Nurse Practitioner | 3450 N Rock Rd Ste 503, Wichita, KS 67226-1355 | 2017-05-03 |
| 1245582741 | Teresa B Jackson | Audiologist-Hearing Aid Fitter | 2001 Lincoln Dr W, Suite E, Marlton, NJ 08053-1531 | 2012-10-08 |
| 1194001677 | Teresa Leigh Jackson | Nurse Practitioner | 222 22nd Ave N, Suite 400, Nashville, TN 37203 | 2011-10-27 |
| 1700016300 | Teresa C Jackson | Nurse Practitioner | 2780 Bob Wallace Ave Sw, Huntsville, AL 35805-4104 | 2009-07-17 |
| Street Address |
4010 S MULBERRY ST |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-7000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700842218 | Darrell R Over | Family Medicine | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2006-04-24 |
| 1912492943 | Michael Falaye | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-06-22 |
| 1720575822 | Vinian R Richards | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-16 |
| 1265939342 | Michael May | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
| 1922505080 | Abdulmattaleb Al Soufi | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
| 1811494974 | Jheanelle Dawkins | Family Medicine | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
| 1336646496 | Robert Ferguson | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
| 1841797933 | Gireesh Sadasivan | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
| 1326545401 | Todd Firmatura | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
| 1043745508 | Samuel Henderson | Family Medicine | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2017-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 246QM0706X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Medical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425297 | Elizabeth Byington | Spec/Tech, Pathology | 918 Lake Crest Dr, Jonesboro, AR 72404-9566 | 2020-10-20 |
| 1023410735 | Lana Hamilton | Spec/Tech, Pathology | 2641 Clayburne Dr, Jonesboro, AR 72401-8160 | 2014-09-24 |
| 1144595216 | Eric Ashcraft | Spec/Tech, Pathology | 1445 J A Jones Dr, Benton, AR 72019-6907 | 2012-03-21 |
| 1184249039 | Thao Vu | Spec/Tech, Pathology | 1 Childrens Way, Little Rock, AR 72202-3500 | 2020-06-16 |
| 1396201125 | Mayri Rodriguez | Spec/Tech, Pathology | 4301 W Markham St, Little Rock, AR 72205-7101 | 2019-02-18 |
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on TERESA 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.