NICOLE JACKSON FNP NPI 1366974628

NPI Information

NPI: 1366974628
Provider Name: NICOLE JACKSON, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: ANEW MENTAL HEALTH

PECOS Registration: Yes

Address:
1020 FORREST AVE
DOVER, DE
ZIP 19904
Phone: (302) 652-2455
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Nicole Jackson, FNP is a family nurse practitioner in Dover, DE with 8 years of experience. Nicole Jackson, FNP NPI is 1366974628. 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:

1020 FORREST AVE
DOVER, DE
ZIP 19904-799
Phone: (302) 652-2455
Fax: (302) 322-6251

The NPI 1366974628 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 3/28/2017 and was last updated on 11/11/2019.

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	363L00000X	Nurse Practitioner		LG0001029	DELAWARE	No
2	363LF0000X	Nurse Practitioner	Family	LG0001029	DELAWARE	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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