MARY K JACKSON NPI 1083967269

NPI Information

NPI: 1083967269
Provider Name: MARY K JACKSON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: CENTRIC HEALTH

PECOS Registration: Yes

Address:
420 34TH ST
BAKERSFIELD, CA
ZIP 93301
Phone: (661) 327-4647
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Mary K Jackson is a family nurse practitioner in Bakersfield, CA with 12 years of experience. Mary K Jackson NPI is 1083967269. 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:

420 34TH ST
BAKERSFIELD, CA
ZIP 93301-237
Phone: (661) 327-4647

The NPI 1083967269 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 10/24/2012 and was last updated on 11/28/2012.

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	AP06911	LOUISIANA	No
2	363LF0000X	Nurse Practitioner	Family	22098	CALIFORNIA	Yes

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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