HEIDI A JACKSON ARNP NPI 1508942954

NPI Information

NPI: 1508942954
Provider Name: HEIDI A JACKSON, ARNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
261 N ROOSEVELT AVE
CHANDLER, AZ
ZIP 85226
Phone: (480) 305-2888
Get Directions

Heidi A Jackson, ARNP is a family nurse practitioner in Chandler, AZ. Heidi A Jackson, ARNP NPI is 1508942954. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

261 N ROOSEVELT AVE
CHANDLER, AZ
ZIP 85226-616
Phone: (480) 305-2888
Fax: (480) 305-2889

The NPI 1508942954 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/28/2006 and was last updated on 1/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	F332937	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	061494923	OTHER	TIN
2	MJ0564117	OTHER	DEA
3	510793	OTHER	RN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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