KEISHA PERRY JACKSON PMHNP NPI 1972336923

NPI Information

  • NPI: 1972336923
  • Provider Name: KEISHA PERRY JACKSON, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 988 USS JAMES MADISON RD
    BUILDING 1028
    KINGS BAY, GA
    ZIP 31547
  • Phone: (912) 573-6578

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NPI Details

Keisha Perry Jackson, PMHNP is a psychiatric/mental health nurse practitioner in Kings Bay, GA. Keisha Perry Jackson, PMHNP NPI is 1972336923. 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:

988 USS JAMES MADISON RD
BUILDING 1028
KINGS BAY, GA
ZIP 31547
Phone: (912) 573-6578
Fax: (912) 573-2597

The enumeration date for this NPI number is 8/24/2024 and was last updated on 1/8/2026.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health906900MISSISSIPPIYes

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

NPI Synchronization or Removal

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