KATHLEEN J. JACKSON (NPI# 1073619037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073619037 |
| Entity Type | Individual |
| Full Name | KATHLEEN J. JACKSON |
| Credential | RN-APN |
| Practice Address |
1001 F Lincoln Drive, West Cooper Familyl Medicine PC Marlton NJ 08053-1915 |
| Mailing Address |
3 Cooper Plz Suite 502 Camden NJ 08103-1438 |
| Practice Telephone | 8568101800 |
| Practice Fax Number | 8568101879 |
| Mailing Telephone | 8569636888 |
| Mailing Fax Number | 8569688499 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2010-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | TP001754C | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
26NN06425500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
26NN06425500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | CIGNA | 9765851 | 01 |
| NJ | HORIZON NJ HEALTH | 60037187 | 01 |
| NJ | 8780803 | 05 | |
| NJ | OXFORD/UNITED HLTH. | P3845837/2854869 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427699685 | Kathleen Jackson | Technician | 3788 Jackson Community Rd, Vernon, FL 32462-3440 | 2019-09-30 |
| 1508015421 | Kathleen Jackson | Licensed Practical Nurse | 188 Lovering Ave, Buffalo, NY 14216-1814 | 2008-09-16 |
| 1629264759 | Kathleen Lux Jackson | Registered Nurse | 2894 Komaia Pl, Honolulu, HI 96822-1745 | 2007-09-21 |
| 1508964347 | Kathleen Jackson | Registered Nurse | 7702 W Thurston Ave, Milwaukee, WI 53218 | 2006-09-20 |
| 1548236029 | Kathleen Anne Jackson | Internal Medicine | 147 S 52nd Pl, Springfield, OR 97478-6210 | 2006-02-24 |
| 1538720305 | Kathleen Celeste Jackson | Pharmacist | 181 Taylor Ave, Columbus, OH 43203-1779 | 2019-06-24 |
| 1801323993 | Kathleen Marie Jackson | Student in an Organized Health Care Education/Training Program | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2017-05-19 |
| 1356893689 | Kathleen Anne Jackson | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2016-11-03 |
| 1720496326 | Kathleen Grace Jackson | Physical Therapist | 590 S Wakara Way, Salt Lake City, UT 84108-1200 | 2014-07-27 |
| 1699108209 | Kathleen Adele Jackson | Nurse Practitioner | 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 | 2013-08-19 |
| Street Address |
1001 F LINCOLN DRIVE, WEST COOPER FAMILYL MEDICINE PC |
| City | MARLTON |
| State | NJ |
| Zip Code | 08053-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619509288 | South Jersey Coping Clinic | Counselor | 525 Nj Route 73 South, Ste 306, Marlton, NJ 08053 | 2020-02-11 |
| 1780216952 | Aba Residential | Psychologist | 7 Cooper Ave Suit A, Marlton, NJ 08053 | 2020-02-06 |
| 1003447400 | Forrest Mark Waterman | Optometrist | 928 Nj-73, Evesham Township, NJ 08053 | 2020-02-04 |
| 1124666862 | Bh Brightview Greentree Opco, LLC | Alzheimer Center (Dementia Center) | 170 Grrentree Road, Marlton, NJ 08053 | 2019-12-12 |
| 1780226597 | Cassandra Ann Pistorius | Counselor | 77 Lakeside Dr, Marlton, NJ 08053 | 2019-10-14 |
| 1265099741 | Jessica Strassle | Occupational Therapist | 751 Nj-73, Suite 1, Marlton, NJ 08053 | 2019-05-21 |
| 1972169902 | Jefferson University Radiology Associates, LLC | Radiology | 999 Nj-73, # 101, Marlton, NJ 08053 | 2019-05-15 |
| 1235692120 | Liberty Corner Surgical Center At Marlton LLC | Clinic/Center | 95 Marlton Pike West, Marlton, NJ 08053 | 2019-04-09 |
| 1063995769 | Genesis Counseling Center, Inc. | Counselor | 2003 C Lincoln Dr. W., Marlton, NJ 08053 | 2018-09-10 |
| 1659853414 | Erika V Colbert | Nurse Practitioner | 1 Eves Drive 134, 134, Marlton, NJ 08053 | 2018-08-29 |
| Find all providers in zip 08053 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659997971 | Jessica H Costa | Nurse Practitioner | 750 Route 73 S Ste 210, Marlton, NJ 08053-4133 | 2020-06-23 |
| 1710443049 | Rebecca L Kelly | Nurse Practitioner | 750 Route 73 S Ste 401, Marlton, NJ 08053-4145 | 2019-02-12 |
| 1679086805 | Agata Patrycja Kraszewska | Nurse Practitioner | 773 Route 70 E Ste E125, Marlton, NJ 08053 | 2017-11-09 |
| 1215447446 | Jennifer Kover | Nurse Practitioner | 525 Route 73 S Ste 102, Marlton, NJ 08053-9643 | 2017-10-02 |
| 1538520275 | Jonelle Allen | Nurse Practitioner | 901 Route 73 North, Suite C, Marlton, NJ 08053 | 2016-03-08 |
| 1093330201 | Shainna Alise Mckenzie | Nurse Practitioner | 5 Eves Dr, Marlton, NJ 08053-3135 | 2020-06-12 |
| 1376002444 | Michelle L Henritzy | Nurse Practitioner | 701 Route 73 N Ste 7, Marlton, NJ 08053 | 2019-03-18 |
| 1780140483 | Danielle Imparato | Nurse Practitioner | 330 Greentree Rd, Marlton, NJ 08053-9427 | 2019-02-18 |
| 1982168522 | Dzmitry Limarenka | Nurse Practitioner | 90 Brick Rd Fl 3, Marlton, NJ 08053-2177 | 2019-01-28 |
| 1932676921 | Alexandra Lee Meyer | Nurse Practitioner | 141 Route 70 E Ste B, Marlton, NJ 08053 | 2018-10-27 |
| Find all providers in MARLTON | ||||
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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.