SHELLI M JACKSON CRNP NPI 1467798553

NPI Information

NPI: 1467798553
Provider Name: SHELLI M JACKSON, CRNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
2602 WILMINGTON RD STE 200
NEW CASTLE, PA
ZIP 16105
Phone: (724) 657-3204
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Shelli M Jackson, CRNP is an acute care nurse practitioner in New Castle, PA with 12 years of experience. Shelli M Jackson, CRNP NPI is 1467798553. 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:

2602 WILMINGTON RD STE 200
NEW CASTLE, PA
ZIP 16105-538
Phone: (724) 657-3204
Fax: (724) 652-7144

The NPI 1467798553 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 12/18/2012 and was last updated on 12/18/2012.

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	363LA2100X	Nurse Practitioner	Acute Care	SP012348	PENNSYLVANIA	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: 5/5/2024

NPI Synchronization or Removal

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