MRS. DANI KATHLEEN JACKSON CPNP-PC NPI 1104563188

NPI Information

NPI: 1104563188
Provider Name: MRS. DANI KATHLEEN JACKSON, CPNP-PC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
1 CHILDRENS PL # 2N90
SAINT LOUIS, MO
ZIP 63110
Phone: (573) 201-9490
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MRS. Dani Kathleen Jackson, CPNP-PC is a pediatrics nurse practitioner in Saint Louis, MO. MRS. Dani Kathleen Jackson, CPNP-PC NPI is 1104563188. 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:

1 CHILDRENS PL # 2N90
SAINT LOUIS, MO
ZIP 63110-002
Phone: (573) 201-9490
Fax: (314) 454-4340

The enumeration date for this NPI number is 5/19/2022 and was last updated on 5/19/2022.

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	363LP0200X	Nurse Practitioner	Pediatrics	2022005949	MISSOURI	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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