KIMCHEREE JACKSON (NPI# 1083093355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083093355 |
| Entity Type | Individual |
| Full Name | KIMCHEREE JACKSON |
| Practice Address |
4930 E Lake Mary Blvd Sanford FL 32771-5003 |
| Practice Telephone | 4073228645 |
| Mailing Telephone | 4073228645 |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2020-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9250679 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4930 E LAKE MARY BLVD |
| City | SANFORD |
| State | FL |
| Zip Code | 32771-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901497 | Hector Octaviani | Pediatrics | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2005-06-13 |
| 1093349433 | Marcell Bailey | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2020-02-25 |
| 1174157614 | Gloria Isabel Torrens | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2020-02-24 |
| 1720627300 | Wendy Joseph | Family Medicine | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2019-12-31 |
| 1942706585 | Allison Conley | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2018-04-03 |
| 1215435151 | Candace Folch | Physician Assistant | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2018-01-25 |
| 1134514870 | Myra White | Advanced Practice Midwife | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2015-03-31 |
| 1760875124 | Theresa Laura Mantle | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2015-03-10 |
| 1700291176 | Luisa Ozema Mena | General Practice | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2014-06-24 |
| 1376953836 | Emma M Herrera | General Practice | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2014-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134695224 | Sheena L Grayson | Pharmacist | 4942 W State Rd 46, Suite 1014, Sanford, FL 32771 | 2018-10-16 |
| 1699284299 | Christopher Ryan King | Chiropractor | 1026 Old England Loop, Sanford, FL 32771 | 2017-09-26 |
| 1669991345 | Scarlett Sierra | Counselor | 401 W Seminole Blvd, Sanford, FL 32771 | 2017-09-14 |
| 1881132249 | Tracy Shibla | Nurse Practitioner | 2320 Retreat View Cir, Sanford, FL 32771 | 2017-02-06 |
| 1205387206 | Tabitha Boyd | Behavior Technician | 4136 Geranium Ln #102, Sanford, FL 32771 | 2016-10-14 |
| 1104275874 | Jessica Willis | Nurse Anesthetist, Certified Registered | 108 Temple Dr, Sanford, FL 32771 | 2016-06-03 |
| 1013379957 | Bai Medical LLC | Point of Service | 580 Lexington Green Lane, Sanford, FL 32771 | 2016-03-21 |
| 1710347851 | Melissa T Ramsawak | Nurse Practitioner | 4930 East Lake Mary Boulevard, Sanford, FL 32771 | 2016-03-02 |
| 1811394570 | Tanesha Burns | Counselor | 209 San Carlos Ave Ste 111a, Sanford, FL 32771 | 2014-11-24 |
| 1053717322 | Amy Hertz, Dmd and Minta Lopez-torres, Dmd | Dentist | 5030 West Sr 46, Suite 1018, Sanford, FL 32771 | 2014-11-13 |
| Find all providers in zip 32771 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083245674 | Kimberly Nicole Clinton | Nurse Practitioner | 321 Wilton Cir, Sanford, FL 32773-4938 | 2020-02-01 |
| 1164938072 | Elzbieta Kubek | Nurse Practitioner | 147 Pine Isle Dr, Sanford, FL 32773-7436 | 2017-12-15 |
| 1831626928 | Kay Williams | Nurse Practitioner | 1024 S Horner Blvd, Sanford, NC 27330-5323 | 2017-05-19 |
| 1952502957 | Kelly Dawn Buie Jones | Nurse Practitioner | 106 Hillcrest Drive, Sanford, NC 27330 | 2007-05-29 |
| 1467574699 | Anita Martin | Nurse Practitioner | 520 W Lake Mary Blvd Ste 214, Sanford, FL 32773 | 2007-04-06 |
| 1851475438 | Christine Anne Lupienski | Nurse Practitioner | 1915 K M Wicker Memorial Dr, Sanford, NC 27330-5070 | 2006-10-24 |
| 1376637983 | Anna M. Pitts | Nurse Practitioner | 308 North Entrance Road, Sanford, FL 32771 | 2006-10-03 |
| 1093826661 | Seth A Brooker | Nurse Practitioner | 25a June St Ste 11, Sanford, ME 04073 | 2006-08-31 |
| 1609852086 | Steven Petrin | Nurse Practitioner | 25 June St, Sanford, ME 04073-2621 | 2005-12-19 |
| 1578112959 | Kelli Marie Baker | Nurse Practitioner | 1411 Greenway Ct, Sanford, NC 27330-6954 | 2019-09-08 |
| Find all providers in SANFORD | ||||
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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.