BRUCE JACKSON RN FA NPI 1598133571

NPI Information

NPI: 1598133571
Provider Name: BRUCE JACKSON, RN, FA
Classification: Registered Nurse - 163WX0800X
Entity Type: Individual

Specialization: Orthopedic

Address:
2828 1ST AVE STE 400
HUNTINGTON, WV
ZIP 25702
Phone: (304) 525-6905
Get Directions

Bruce Jackson, RN, FA is an orthopedic registered nurse in Huntington, WV. Bruce Jackson, RN, FA NPI is 1598133571. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2828 1ST AVE STE 400
HUNTINGTON, WV
ZIP 25702-236
Phone: (304) 525-6905
Fax: (304) 525-4316

The enumeration date for this NPI number is 9/9/2015 and was last updated on 9/9/2015.

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	163WX0800X	Registered Nurse	Orthopedic	398466	OHIO	No
2	163WX0800X	Registered Nurse	Orthopedic	60256	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	SC9270053	MEDICARE PIN	OHIO
2	0010681000	MEDICAID	WEST VIRGINIA
3	352265	MEDICAID	OHIO
4	SC9270051	MEDICARE PIN	WEST VIRGINIA

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: 4/28/2024

NPI Synchronization or Removal

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