MRS. KRISTIE LYNN JACKSON (NPI# 1053407817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053407817 |
| Entity Type | Individual |
| Full Name | MRS. KRISTIE LYNN JACKSON |
| Credential | NP |
| Practice Address |
3700 South Main Street Blacksburg VA 24060 |
| Mailing Address |
2900 Mudpike Road Christiansburg VA 24073 |
| Practice Telephone | 5409535385 |
| Mailing Telephone | 5403829139 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024167104 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639629454 | Kristie Jackson | Counselor | 1644 Carter St, Suite 2, Vidalia, LA 71373-3143 | 2016-10-04 |
| 1194001560 | Kristie Michelle Jackson | Counselor | 3080 W 3rd St, Elk City, OK 73644-4323 | 2011-10-28 |
| 1891765970 | Kristie Jackson | Nurse Practitioner | 4230 Harding Pike, Suite 330, Nashville, TN 37205 | 2006-01-23 |
| Street Address |
3700 SOUTH MAIN STREET |
| City | BLACKSBURG |
| State | VA |
| Zip Code | 24060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053622167 | Holli Dezaun Waller | Family Medicine | 3700 South Main Street, Blacksburg, VA 24060 | 2010-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144789215 | Center for Cognition, Language & Speech, LLC | Speech-Language Pathologist | 1999 South Main St., Suite 303, Blacksburg, VA 24060 | 2019-03-18 |
| 1669945465 | Hannah Jacqueline Lower | Physical Therapy Assistant | Kroontje Healthcare Center, 100 Litton Lane, Blacksburg, VA 24060 | 2019-01-04 |
| 1720568637 | Amy Butler | Nurse Practitioner | Blue Ridge Cancer Center, 2955 Research Drive, Blacksburg, VA 24060 | 2018-08-20 |
| 1134615321 | Benjamin Toliver Matthews | Dentist | 1400 S. Main St, Ste 1, Blacksburg, VA 24060 | 2018-07-10 |
| 1881107100 | New River Periodontics and Dental Implant Center, PC | Dentist | 2612 Sheffield Drive, Blacksburg, VA 24060 | 2017-11-08 |
| 1316333685 | Access and Mobility | Durable Medical Equipment & Medical Supplies | 2536 Blossom Trail West, Blackburg, VA 24060 | 2015-04-13 |
| 1326485202 | Kristopher Joel Hansen | Internal Medicine | 2600 Research Center Dr Ste A, Blacksburg, VA 24060 | 2013-05-31 |
| 1891038949 | Holly P. Martin | Physician Assistant | 3706 South Main Street, Suite D, Blacksburg, VA 24060 | 2013-03-27 |
| 1174875330 | Catawba Hospital | Chronic Disease Hospital | 1801 Glade Road, Blacksburg, VA 24060 | 2012-10-11 |
| 1083964316 | Karla Sue Soukup | Marriage & Family Therapist | 510 S. Main Street, Blackburg, VA 24060 | 2012-09-13 |
| Find all providers in zip 24060 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053937755 | Amanda Mitchell Hale | Nurse Practitioner | 829 Davis St, Blacksburg, VA 24060-7013 | 2020-06-19 |
| 1720568637 | Amy Butler | Nurse Practitioner | Blue Ridge Cancer Center, 2955 Research Drive, Blacksburg, VA 24060 | 2018-08-20 |
| 1003346412 | Gwendolyn Williams Spangler | Nurse Practitioner | 2600 Research Center Dr # A, Blacksburg, VA 24060-6325 | 2017-06-18 |
| 1750774782 | Charlene Rae Viers | Nurse Practitioner | 901 Plantation Rd Ste 1, Blacksburg, VA 24060-3880 | 2015-03-16 |
| 1427114610 | Cynthia Hartman Gibbons | Nurse Practitioner | 303 Church St Se, Blacksburg, VA 24060-4805 | 2006-12-29 |
| 1588777221 | Ann Morris Shawhan | Nurse Practitioner | 1715 Pratt Dr, Suite 1100, Blacksburg, VA 24060-6385 | 2006-08-16 |
| 1992705941 | Barbara R Miller | Nurse Practitioner | 2617 Sheffield Dr, New River Dermatology, Blacksburg, VA 24060-8271 | 2005-07-29 |
| 1235699901 | Alesia Nicole Mcfarlin | Nurse Practitioner | 301 W Pine St, Blacksburg, SC 29702-1549 | 2019-03-20 |
| 1891284295 | Shannon Lowry | Nurse Practitioner | 215 Gilbert St, Blacksburg, VA 24060-3305 | 2018-05-02 |
| 1366956278 | Gloria Kim | Nurse Practitioner | 700 University City Blvd, Blacksburg, VA 24060-2706 | 2017-11-30 |
| Find all providers in BLACKSBURG | ||||
| City | BLACKSBURG |
| Zip Code | 24060 |
Please comment or provide details below to improve the information on MRS. KRISTIE LYNN JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.