ANJANEAN JACKSON (NPI# 1639524002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639524002 |
| Entity Type | Individual |
| Full Name | ANJANEAN JACKSON |
| Credential | NP |
| Practice Address |
4321 Hartley Bridge Rd Macon GA 31216-5641 |
| Mailing Address |
2620 Elm Hill Pike Nashville TN 37214-3108 |
| Practice Telephone | 4787882046 |
| Mailing Telephone | 6154254200 |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN198259 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4321 HARTLEY BRIDGE RD |
| City | MACON |
| State | GA |
| Zip Code | 31216-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568496305 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2006-07-10 |
| 1215560123 | Jennifer Anne Mcculley | Pharmacist | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2020-02-19 |
| 1699306134 | Patrenice Thomas | Pharmacist | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2020-02-03 |
| 1962033308 | Donald Allen Cooper | Pharmacist | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2020-02-03 |
| 1386193571 | Tlc of Georgia LLC | Physician Assistant | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2016-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125282 | Georgia Treatment Services | Clinic/Center | 6132 Hawkinsvill Road, Macon, GA 31216 | 2019-07-02 |
| 1720495898 | Erma Wells Heard | Nurse Practitioner | 217 Pendleton Ct., Macon, GA 31216 | 2014-07-21 |
| 1881959518 | Leigh Underwood Bennett | Dentist | 4226 Hartley Bridge Rd Ste 102, Macon, GA 31216 | 2012-07-09 |
| 1295980456 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 4585 Hartley Bridge Rd., Macon, GA 31216 | 2008-12-01 |
| 1013083336 | Rutland Medical Supply | Durable Medical Equipment & Medical Supplies | 3035 Hartley Bridge Road, Suite 2, Macon, GA 31216 | 2006-11-28 |
| 1477074318 | Hollie K Bradley | Nurse Practitioner | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2017-06-30 |
| 1104206713 | Hartley Bridge Family Dentistry | Dentist | 4226 Hartley Bridge Rd Ste 102, Macon, GA 31216 | 2015-06-09 |
| 1144432048 | Family Specialty Care LLC | Family Medicine | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2007-05-04 |
| 1164598710 | Kirsten J Hampton | Family Medicine | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2006-11-27 |
| 1063588614 | Cameka N Scarborough | Family Medicine | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2006-11-27 |
| Find all providers in zip 31216 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| 1578160560 | Ida Mayaka | Nurse Practitioner | 210 Autumn Trace Ct, Macon, GA 31210-8025 | 2020-10-03 |
| 1427664465 | Shanna Lynn Beaulieu | Nurse Practitioner | 781 Spring St Ste 230, Macon, GA 31201-2185 | 2020-09-16 |
| 1467070557 | Raquel Simmons | Nurse Practitioner | 670 Ivy Brook Way, Macon, GA 31210-5520 | 2020-07-06 |
| 1174159800 | Jamie K Polk | Nurse Practitioner | 3951 Ridge Ave Ste C, Macon, GA 31210-5064 | 2020-03-13 |
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1730730581 | Lindsay Fernandez | Nurse Practitioner | 102 Saint Johns Pl, Macon, GA 31210-8606 | 2019-09-24 |
| 1003468240 | Skylar Nelson | Nurse Practitioner | 330 Hospital Dr Ste 200, Macon, GA 31217-8034 | 2019-07-09 |
| 1861051880 | Courtney Elizabeth Avery | Nurse Practitioner | 540 Charter Blvd Ste 400, Macon, GA 31210-4882 | 2019-06-12 |
| 1376101196 | Detra K Dixon | Nurse Practitioner | 227 Amalie Dr, Macon, GA 31220-2667 | 2019-06-05 |
| Find all providers in MACON | ||||
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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.