KIMMERLY JACKSON FNP NPI 1972366086

NPI Information

  • NPI: 1972366086
  • Provider Name: KIMMERLY JACKSON, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 184 BARTON ST
    BUFFALO, NY
    ZIP 14213
  • Phone: (716) 881-6191

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NPI Details

Kimmerly Jackson, FNP is a family nurse practitioner in Buffalo, NY. Kimmerly Jackson, FNP NPI is 1972366086. 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:

184 BARTON ST
BUFFALO, NY
ZIP 14213-573
Phone: (716) 881-6191
Fax: (716) 881-6247

The NPI 1972366086 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 2/1/2024 and was last updated on 2/1/2024.

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
1363LF0000XNurse PractitionerFamily353174NEW YORKYes

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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