AMIE KATHLEEN JACKSON NPI 1679053821

NPI Information

  • NPI: 1679053821
  • Provider Name: AMIE KATHLEEN JACKSON
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1130 GARBRY RD
    PIQUA, OH
    ZIP 45356
  • Phone: (513) 941-4999

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NPI Details

Amie Kathleen Jackson is a family nurse practitioner in Piqua, OH. Amie Kathleen Jackson NPI is 1679053821. 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:

1130 GARBRY RD
PIQUA, OH
ZIP 45356-217
Phone: (513) 941-4999
Fax: (513) 694-0168

The NPI 1679053821 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 8/17/2018 and was last updated on 12/13/2024.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)CDCA.176328OHIONo
2101YA0400XCounselorAddiction (Substance Use Disorder)CDCA.179912OHIONo
3163W00000XRegistered NurseRN.376287OHIONo
4363LF0000XNurse PractitionerFamilyAPRN.CNP.023408OHIOYes

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 Other Provider Identifier Issuer
10311836MEDICAIDOHIO

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: 11/21/2025

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