TIFFANY MICHELLE JACKSON (NPI# 1073161642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073161642 |
| Entity Type | Individual |
| Full Name | TIFFANY MICHELLE JACKSON |
| Credential | FNP-C |
| Practice Address |
4982 Peppers Ferry Rd Wytheville VA 24382-4966 |
| Practice Telephone | 2762391721 |
| Mailing Telephone | 2762391721 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 0001197595 | VA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024178133 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902432875 | Tiffany Jackson | Technician | 712 N Jenison Ave, Lansing, MI 48915-1309 | 2020-03-23 |
| 1336781335 | Tiffany Lashun Jackson | Contractor | 1718 Northside Dr Apt O3, Valdosta, GA 31602-1558 | 2019-10-10 |
| 1245892694 | Tiffany Nicole Jackson | Counselor | 6292 Dyke Rd, Chittenango, NY 13037-9404 | 2019-07-06 |
| 1851875116 | Tiffany Andrea Jackson | Case Manager/Care Coordinator | 1095 Golden Lakes Blvd Apt 913, West Palm Beach, FL 33411-3353 | 2018-09-21 |
| 1992046734 | Tiffany Jackson | Licensed Practical Nurse | 4746 Walford Rd Apt 2, Warrensville Heights, OH 44128-5151 | 2013-03-04 |
| 1871801399 | Tiffany Jan'nelle Jackson | Dentist | 2550 Windmill Ln Ste 145, Henderson, NV 89074-5500 | 2010-09-17 |
| 1619289212 | Tiffany C. Jackson | Massage Therapist | 904 S Main St, Pleasant Grove, UT 84062-3560 | 2010-07-12 |
| 1851613251 | Tiffany Renee Jackson | Contractor | 5533 Litchfield St, Philadelphia, PA 19143-4714 | 2010-02-25 |
| 1942491063 | Tiffany R Jackson | Obstetrics & Gynecology | 7217 Telecom Parkway, Suite 290, Garland, TX 75044 | 2007-08-05 |
| 1952501553 | Tiffany Hope Jackson | Counselor | 14811 Sabine Dr, La Mirada, CA 90638-2144 | 2007-07-20 |
| Street Address |
4982 PEPPERS FERRY RD |
| City | WYTHEVILLE |
| State | VA |
| Zip Code | 24382-4966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709118 | Pt Solutions LLC | Physical Therapist | 1050 Holston Road, Wytheville, VA 24382 | 2020-01-10 |
| 1881233377 | Amie S Newberry | Physical Therapist | 1050 Holston Rd, Wytheville, VA 24382 | 2019-12-31 |
| 1174160618 | Erin Leigh Dejesus | Family Medicine | 375 W Ridge Rd, Wytheville, VA 24382 | 2019-12-03 |
| 1629639497 | Family Preservatrion Services, Inc. | Community/Behavioral Health | 425 Grayson Presbyterian Road, Wytheville, VA 24382 | 2019-06-24 |
| 1023527926 | Emily Kingrey | Occupational Therapist | 800 E Main St., Suite 310, Wytheville, VA 24382 | 2017-09-22 |
| 1184149247 | Linda Huber | Driver | 610 E Washington St, Wytheville, VA 24382 | 2017-08-10 |
| 1578987558 | Family Preservation Services, Inc | Community/Behavioral Health | 695 East Marshall Street, Wytheville, VA 24382 | 2014-02-11 |
| 1255774121 | Forest Pharmacy Inc | Pharmacy | 1787 W Lee Highway, Suite B, Wytheville, VA 24382 | 2013-04-10 |
| 1447500400 | Guardian Pharmacy of Virginia LLC | Pharmacy | 860 Stafford Umberger Dr, Wytheville, VA 24382 | 2012-09-17 |
| 1669604385 | Catherine Elizabeth Russell | Physical Therapist | 710 West Ridge Rd, Suites E & F, Wytheville, VA 24382 | 2009-08-13 |
| Find all providers in zip 24382 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114464963 | Kimberly Nichole Horton | Nurse Practitioner | 1375 West Ridge Road, Wytheville, VA 24382-0718 | 2017-01-31 |
| 1962757369 | Molly L Johnson | Nurse Practitioner | 210 Pepsi Way, Wytheville, VA 24382-3030 | 2012-07-21 |
| 1972138493 | Tammy Lynn Guinn | Nurse Practitioner | 600 W Ridge Rd, Wytheville, VA 24382-1044 | 2020-03-04 |
| 1306314612 | Erin Elizabeth Justice | Nurse Practitioner | 245 Holston Rd Ste B, Wytheville, VA 24382-4486 | 2018-11-05 |
| 1851875710 | Andrew Preston Widener | Nurse Practitioner | 600 W Ridge Rd, Wytheville, VA 24382-1044 | 2018-09-17 |
| 1346756996 | Beth Shavon Dalton | Nurse Practitioner | 1785 W Lee Hwy, Wytheville, VA 24382-1437 | 2017-12-19 |
| 1811409048 | Amanda Michelle Arnold | Nurse Practitioner | 450 W Monroe St, Wytheville, VA 24382-2236 | 2017-10-27 |
| 1063921625 | Cassie Ann Sheffey | Nurse Practitioner | 1375 W Ridge Rd, Wytheville, VA 24382-5011 | 2017-09-27 |
| 1619490307 | Leslie Sullins | Nurse Practitioner | 450 W Monroe St, Wytheville, VA 24382-2236 | 2017-07-25 |
| 1306367149 | Amanda Stoots Wright | Nurse Practitioner | 342 Virginia Ave, Wytheville, VA 24382-1185 | 2017-07-02 |
| Find all providers in WYTHEVILLE | ||||
| City | WYTHEVILLE |
| Zip Code | 24382 |
Please comment or provide details below to improve the information on TIFFANY MICHELLE 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.