MRS. MAHALIA L JACKSON-BUTLER (NPI# 1063669893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063669893 |
| Entity Type | Individual |
| Full Name | MRS. MAHALIA L JACKSON-BUTLER |
| Other Name | MRS. MAHALIA L JACKSON |
| Practice Address |
4621 S Cooper St Ste 131-717 Arlington TX 76017-5866 |
| Practice Telephone | 2142772243 |
| Practice Fax Number | 2142312926 |
| Mailing Telephone | 2142772243 |
| Mailing Fax Number | 2142312926 |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2020-09-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
715590 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 201844201 | 05 |
| Street Address |
4621 S COOPER ST STE 131-717 |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76017-5866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528330792 | Medi- Elite, PC | Nurse Practitioner | 4621 S Cooper St Ste 131-717, Arlington, TX 76017-5866 | 2012-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972149714 | Elite Vision Center | Optometrist | 5335 W. Sublett Road, Suite 600, Arlington, TX 76017 | 2019-11-26 |
| 1497390694 | Ijeoma Esther Osuji | Nurse Practitioner | 5307 Alta Vista Lane, Arlington, TX 76017 | 2019-11-12 |
| 1003385386 | Peace Within | Counselor | 5904 S. Cooper Ste. 104 - Pmb 162, Arlington, TX 76017 | 2018-11-16 |
| 1750883229 | Lumin Health Physician Group, Pa | Pain Medicine | 808 W Interstate 20 Suite 201, Arlington, TX 76017 | 2018-03-01 |
| 1215438643 | Clover Francis | Licensed Vocational Nurse | 5211 Saratoga Lane, Arlington, TX 76017 | 2018-02-21 |
| 1265942593 | Maria Luisa Gonzalez | Community Health Worker | 5916 Wind Drift Trail, Arllington, TX 76017 | 2017-09-29 |
| 1285150318 | Divya Patel | Counselor | 5201 Windy Meadow Drive, Arlington, TX 76017 | 2017-08-21 |
| 1912420217 | Natalia Sampaio Goodwin | Registered Nurse | 811 W. Interstate 20, Suite 212, Arlington, TX 76017 | 2017-07-19 |
| 1962939744 | Sean Christopher Hembree | Chiropractor | 4304 Sw Green Oaks Blvd Ste 150, Arlington, TX 76017 | 2017-05-11 |
| 1154866119 | Deborah Tuckey Nystrom | Physical Therapist | 2310 West I-20, Suite 204, Arlington, TX 76017 | 2016-12-30 |
| Find all providers in zip 76017 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780216143 | Lakeidre Davis | Nurse Practitioner | 4225 Wingrove Dr, Arlington, TX 76015-4524 | 2020-02-04 |
| 1184277907 | Colleen Claire Slagen | Nurse Practitioner | 29 Trowbridge St, Arlington, MA 02474-5516 | 2019-07-21 |
| 1134621683 | Ntombizodwa Sayi | Nurse Practitioner | 1225 Harris Hawk Way, Arlington, TX 76005 | 2018-03-01 |
| 1003278615 | Donna Green | Nurse Practitioner | 615 East Abrams, Arlington, TX 76010 | 2016-03-23 |
| 1356684401 | Claudia Mary Atherton | Nurse Practitioner | 1625 North George Mason Dr., Virginia Hospital Center, Arlington, VA 22205-3698 | 2013-03-27 |
| 1609198936 | Yonah Knuckles | Nurse Practitioner | 1212 Ruthella Dr, Arlington, TX 76010-3530 | 2010-03-01 |
| 1083882591 | Sue A Piller | Nurse Practitioner | 7244 Collierville Arlington Rd, Arlington, TN 38002-9511 | 2008-02-19 |
| 1497961973 | Jennifer Pitts King | Nurse Practitioner | 1635 N George Mason Dr Ste 490, Arlington, VA 22205-3671 | 2007-05-14 |
| 1053313189 | Kathleen Anne Malliarakis | Nurse Practitioner | 3925 N Abingdon St, Arlington, VA 22207-2919 | 2005-06-01 |
| 1750921391 | Cheyenne Lakota Pagel | Nurse Practitioner | 800 W Arbrook Blvd, Arlington, TX 76015-4327 | 2020-01-12 |
| Find all providers in ARLINGTON | ||||
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| 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.