COURTNEY ELYSE JACKSON NPI 1508494600

NPI Information

NPI: 1508494600
Provider Name: COURTNEY ELYSE JACKSON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2508 SCOTTSVILLE RD STE 104
BOWLING GREEN, KY
ZIP 42104
Phone: (270) 746-6330
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Courtney Elyse Jackson is a family nurse practitioner in Bowling Green, KY. Courtney Elyse Jackson NPI is 1508494600. 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:

2508 SCOTTSVILLE RD STE 104
BOWLING GREEN, KY
ZIP 42104-400
Phone: (270) 746-6330
Fax: (270) 904-6337

The NPI 1508494600 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 4/1/2020 and was last updated on 4/1/2020.

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	363LF0000X	Nurse Practitioner	Family	3013829	KENTUCKY	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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