KATHLEEN ADELE JACKSON (NPI# 1699108209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699108209 |
| Entity Type | Individual |
| Full Name | KATHLEEN ADELE JACKSON |
| Credential | AG-ACNP |
| Practice Address |
1700 University Ave W Fl 6 Saint Paul MN 55104-3727 |
| Mailing Address |
5036 Logan Ave S Minneapolis MN 55419-1018 |
| Practice Telephone | 6512322273 |
| Mailing Telephone | 6129638189 |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2018-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R-169854-7 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427699685 | Kathleen Jackson | Technician | 3788 Jackson Community Rd, Vernon, FL 32462-3440 | 2019-09-30 |
| 1508015421 | Kathleen Jackson | Licensed Practical Nurse | 188 Lovering Ave, Buffalo, NY 14216-1814 | 2008-09-16 |
| 1629264759 | Kathleen Lux Jackson | Registered Nurse | 2894 Komaia Pl, Honolulu, HI 96822-1745 | 2007-09-21 |
| 1508964347 | Kathleen Jackson | Registered Nurse | 7702 W Thurston Ave, Milwaukee, WI 53218 | 2006-09-20 |
| 1073619037 | Kathleen J. Jackson | Nurse Practitioner | 1001 F Lincoln Drive, West, Cooper Familyl Medicine PC, Marlton, NJ 08053-1915 | 2006-09-16 |
| 1548236029 | Kathleen Anne Jackson | Internal Medicine | 147 S 52nd Pl, Springfield, OR 97478-6210 | 2006-02-24 |
| 1538720305 | Kathleen Celeste Jackson | Pharmacist | 181 Taylor Ave, Columbus, OH 43203-1779 | 2019-06-24 |
| 1801323993 | Kathleen Marie Jackson | Student in an Organized Health Care Education/Training Program | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2017-05-19 |
| 1356893689 | Kathleen Anne Jackson | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2016-11-03 |
| 1720496326 | Kathleen Grace Jackson | Physical Therapist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-07-27 |
| Street Address |
1700 UNIVERSITY AVE W FL 6 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-3727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164498739 | Alain F Broccard | Internal Medicine | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2006-02-24 |
| 1912497041 | Pamela Jenness Freske | Psychologist | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2018-05-15 |
| 1376059188 | Meghan Kerry Dunnigan | Nurse Practitioner | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2017-12-17 |
| 1699209643 | Jennifer Leafblad | Social Worker | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2017-04-17 |
| 1033641758 | Megan Lifto | Clinical Nurse Specialist | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2017-03-31 |
| 1841737814 | Alyssa Edwards | Registered Nurse | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2017-01-27 |
| 1811434038 | Sarah Marie Olson | Clinical Neuropsychologist | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2017-01-25 |
| 1801346093 | Caroline Kuria | Nurse Practitioner | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2016-10-11 |
| 1902294358 | Dana Alexandra Peterson | Nurse Practitioner | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2015-01-07 |
| 1225426174 | Hayley Maxwell | Counselor | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2014-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184145914 | Andrea Lueck | Nurse Practitioner | 345 Smith Ave N Ste 301, Saint Paul, MN 55102-2346 | 2017-07-01 |
| 1780209486 | Megan Kipfer | Nurse Practitioner | 225 Smith Ave N Ste 400, Saint Paul, MN 55102-2568 | 2020-06-09 |
| 1427694926 | Katherine Marie Betzel | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2019-11-20 |
| 1700300720 | Jennifer Mikkelson | Nurse Practitioner | 225 Smith Ave N, Saint Paul, MN 55102-2533 | 2017-08-01 |
| 1457778623 | Nicole Kalamitsiotis | Nurse Practitioner | 1700 University Ave W Fl 6, Saint Paul, MN 55104 | 2014-03-25 |
| 1023253945 | Susan Marie Johnson-sickel | Nurse Practitioner | 640 Jackson St, Saint Paul, MN 55101-2502 | 2008-12-05 |
| 1497940860 | The Saint Paul Lung Clinic | Nurse Practitioner | 225 Smith Ave N Ste 300, Saint Paul, MN 55102-2592 | 2007-09-10 |
| 1174717847 | Rebecca Ann Wieben | Nurse Practitioner | 225 Smith Ave N, Suite 300, Saint Paul, MN 55102-2533 | 2007-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043826605 | Angela Jean Splettstoeszer | Nurse Practitioner | 916 Arch Ln Sw, Bemidji, MN 56601-8861 | 2020-09-18 |
| 1316581440 | Northern Lights Health LLC | Nurse Practitioner | 212 W Lake St, Waconia, MN 55387-1014 | 2019-10-31 |
| 1285190132 | Hudson M Omweri | Nurse Practitioner | 1621 Highway 47, Ogilvie, MN 56358-9005 | 2019-02-15 |
| 1871914887 | Brooke Habisch | Nurse Practitioner | 1200 Sixth Ave No Centracare Clinic, Saint Cloud, MN 56303 | 2013-12-17 |
| 1851635502 | Kim Noreen Garrett | Nurse Practitioner | 1703 Bradach Rd, Ely, MN 55731-8041 | 2012-11-19 |
| 1821365305 | Nathaniel I Cree | Nurse Practitioner | 500 Harvard St., Fairview University Hospital, Minneapolis, MN 55455 | 2011-11-28 |
| 1235461419 | Eric Andrew Reyer | Nurse Practitioner | 6401 Sycamore Ln N, Maple Grove, MN 55369-6356 | 2010-02-12 |
| 1457303067 | David A Palm | Nurse Practitioner | Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415 | 2006-05-16 |
| 1972567956 | Michelle D Lewis | Nurse Practitioner | 9900 Bren Rd East, Mail Route Mn 008-b213, Minnetonka, MN 55343-9664 | 2006-04-14 |
| 1679170278 | Paul R Jerve | Nurse Practitioner | 407 E 3rd St, Duluth, MN 55805-1950 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
Please comment or provide details below to improve the information on KATHLEEN ADELE 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.