EMMA J JACKSON NP NPI 1255809372

NPI Information

NPI: 1255809372
Provider Name: EMMA J JACKSON, NP
Classification: Registered Nurse - 163WP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
33048 CANOPY LN
LAKE ELSINORE, CA
ZIP 92532
Phone: (909) 614-3039
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Emma J Jackson, NP is a pediatrics registered nurse in Lake Elsinore, CA. Emma J Jackson, NP NPI is 1255809372. 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:

33048 CANOPY LN
LAKE ELSINORE, CA
ZIP 92532-535
Phone: (909) 614-3039

The NPI 1255809372 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 11/6/2018 and was last updated on 8/7/2020.

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	163W00000X	Registered Nurse		RN95042368	CALIFORNIA	No
2	163WP0200X	Registered Nurse	Pediatrics	95042368	CALIFORNIA	Yes
3	363LF0000X	Nurse Practitioner	Family	NP950147	CALIFORNIA	No

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: 5/5/2024

NPI Synchronization or Removal

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