CARLA JEAN JACKSON-HOWARD (NPI# 1629246665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629246665 |
| Entity Type | Individual |
| Full Name | CARLA JEAN JACKSON-HOWARD |
| Credential | ACNP-BC |
| Practice Address |
1600 N Grand Ave Ste 530 Pueblo CO 81003-2700 |
| Practice Telephone | 7195957790 |
| Practice Fax Number | 7195957799 |
| Mailing Telephone | 7195957790 |
| Mailing Fax Number | 7195957799 |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2010-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
79051 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | CO LICENSE NUMBER | 79051 | 01 |
| Street Address |
1600 N GRAND AVE STE 530 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354763 | Hisman H Percival | Surgery | 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 | 2005-05-31 |
| 1710365416 | Paladina Health, LLC | Family Medicine | 1600 N Grand Ave, Suite 540, Pueblo, CO 81003-2700 | 2015-05-13 |
| 1407249188 | Christopher Traut | Neurological Surgery | 1600 N Grand Ave, Suite 508, Pueblo, CO 81003-2700 | 2015-03-05 |
| 1124423116 | Kati Jo Foechterle | Nurse Practitioner | 1600 N Grand Ave, Suite 140, Pueblo, CO 81003-2700 | 2014-11-03 |
| 1326469248 | Micah Johnson | Physician Assistant | 1600 N Grand Ave, Suite 508, Pueblo, CO 81003-2700 | 2013-12-19 |
| 1720364177 | Anesthesia Management Services, LLC | Nurse Anesthetist, Certified Registered | 1600 N Grand Ave, Suite 420, Pueblo, CO 81003-2700 | 2011-10-31 |
| 1326366105 | Rachel Christine Niemet | Obstetrics & Gynecology | 1600 N Grand Ave, Ste 400, Pueblo, CO 81003-2700 | 2010-05-04 |
| 1306081237 | Neil A Banga | Surgery | 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 | 2008-12-05 |
| 1174770614 | Henrique Jose Fernandez | Internal Medicine | 1600 N Grand Ave, Suite 150, Pueblo, CO 81003-2749 | 2008-08-27 |
| 1831353705 | Marcel Jabour Junqueira | Internal Medicine | 1600 N Grand Ave, Suite 140, Pueblo, CO 81003-2700 | 2008-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679104244 | Nicole Bartolo | Nurse Practitioner | 2152 Gale Rd, Pueblo, CO 81006-1933 | 2020-01-31 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1518206531 | Christopher Dean Trujillo | Nurse Practitioner | 111 W Evans Ave, Pueblo, CO 81004 | 2013-02-11 |
| 1558554188 | Gregory Charles Grahek | Nurse Practitioner | 1925 E Orman Ave Ste A535, Pueblo, CO 81004-3559 | 2007-08-27 |
| 1780703421 | Anna Mae Martinez | Nurse Practitioner | 416 Colorado Ave, Pueblo, CO 81004-2011 | 2007-03-27 |
| 1447319363 | Rose Wertz | Nurse Practitioner | 1925 E Orman Ave Ste A235, Pueblo, CO 81004-3556 | 2006-12-06 |
| 1992327217 | Kristina Reavis | Nurse Practitioner | 400 W 16th St, Pueblo, CO 81003-2781 | 2020-05-08 |
| 1730657636 | Marquez Family Medicine, Ltd. | Nurse Practitioner | 1910 Lake Ave, Pueblo, CO 81004-3322 | 2018-11-08 |
| 1790253128 | Amber Doss | Nurse Practitioner | 3670 Parker Blvd, Pueblo, CO 81008-2285 | 2018-11-03 |
| 1346718855 | Jamison Robert Lester | Nurse Practitioner | 400 W 16th St, Pueblo, CO 81003-2781 | 2018-11-02 |
| Find all providers in PUEBLO | ||||
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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.