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MS. JUDITH JACKSON NURSE PRACTITIONER NPI 1821055880


NPI Information

NPI: 1821055880
Provider Name: MS. JUDITH JACKSON, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2450 RIVERSIDE AVE
MINNEAPOLIS, MN
ZIP 55454
Phone: (612) 672-2288
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MS. Judith Jackson, NURSE PRACTITIONER is a nurse practitioner in Minneapolis, MN with 24 years of experience. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. MS. Judith Jackson, NURSE PRACTITIONER NPI is 1821055880. 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:

2450 RIVERSIDE AVE
MINNEAPOLIS, MN
ZIP 55454-395
Phone: (612) 672-2288

The NPI 1821055880 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 4/26/2006 and was last updated on 7/8/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerR1144729MINNESOTAYes

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: 4/28/2024

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