EVELYN NICOLE JACKSON NPI 1568961837

NPI Information

NPI: 1568961837
Provider Name: EVELYN NICOLE JACKSON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1755 PARR AVE
DYERSBURG, TN
ZIP 38024
Phone: (731) 285-7311
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Evelyn Nicole Jackson is a family nurse practitioner in Dyersburg, TN. Evelyn Nicole Jackson NPI is 1568961837. 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:

1755 PARR AVE
DYERSBURG, TN
ZIP 38024-004
Phone: (731) 285-7311

The NPI 1568961837 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 2/1/2018 and was last updated on 6/30/2021.

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	23714	TENNESSEE	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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