BRITTANY LYNNE JACKSON (NPI# 1114574258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114574258 |
| Entity Type | Individual |
| Full Name | BRITTANY LYNNE JACKSON |
| Credential | APRN, ACNPC-AG |
| Practice Address |
6507 Professional Pl Riverdale GA 30274-4941 |
| Mailing Address |
Po Box 1764 Cartersville GA 30120-1680 |
| Practice Telephone | 4047787777 |
| Mailing Telephone | 7707697147 |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN265101 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958146 | Brittany L Jackson | Midwife | 1619 Dayton Ave Ste 109, Saint Paul, MN 55104-6276 | 2020-06-26 |
| 1992355184 | Brittany Jackson | Social Worker | 1525 Sudbury Ln Apt D, Fairborn, OH 45324-6542 | 2019-09-19 |
| 1265911259 | Brittany M Jackson | Case Manager/Care Coordinator | 908 Jeston Dr, Natchitoches, LA 71457-5908 | 2018-08-09 |
| 1033619606 | Brittany Shea Jackson | Speech-Language Pathologist | 1113 Ridgecrest Cir, Denton, TX 76205-5419 | 2018-02-20 |
| 1487189841 | Brittany Jackson | Counselor | 6210 Glen Echo Dr, Baton Rouge, LA 70812-1737 | 2017-04-24 |
| 1578917258 | Brittany Jackson | Home Health Aide | 5712 Adolpha Ave, Cleveland, OH 44127-1713 | 2016-04-19 |
| 1962825133 | Brittany Jackson | Behavioral Analyst | 464 Common St Ste 106, Belmont, MA 02478-2704 | 2014-01-24 |
| 1376971457 | Brittany Jackson | Physician Assistant | 1404 Palm Ter, Pasadena, CA 91104-5032 | 2013-10-28 |
| 1427679521 | Brittany Elissa Jackson | Behavior Technician | 2400 Se Federal Hwy Ste 220, Stuart, FL 34994-4556 | 2020-04-29 |
| 1346882388 | Brittany Jackson | Behavioral Analyst | 6030 W Oaks Blvd, Rocklin, CA 95765-5491 | 2019-10-10 |
| Street Address |
6507 PROFESSIONAL PL |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-4941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043219256 | Bhat Krishna Mohan | Specialist | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2005-07-19 |
| 1154781714 | Kellie Michelle Noble | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2016-02-24 |
| 1861736803 | Dipti Khanna | Nurse Practitioner | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2012-11-15 |
| 1376768259 | Minnette Williams | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2007-04-16 |
| 1598852436 | Vikram Reddy Mandadi | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-10-10 |
| 1215049440 | Siva B Mohan | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-09-01 |
| 1639128531 | Southern Heart Specialists, P.C. | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-05-08 |
| 1265495444 | Kandathil M. Mathew | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| 1659334829 | Devendra R Koganti | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| 1902869084 | Kuchela Reddy | Internal Medicine | 6507 Professional Pl, Riverdale, GA 30274-4941 | 2006-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447805551 | Nakisha Maria Christian | Nurse Practitioner | 11 Upper Riverdale Rd, Riverdale, GA 30274 | 2019-08-06 |
| 1306333083 | Levi Jelks Jr. | Nurse Practitioner | 83 Upper Riverdale Road, Riverdale, GA 30274-3029 | 2018-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032114 | Candace Buckley | Nurse Practitioner | 244 Ashland Dr, Woodstock, GA 30189-7161 | 2020-10-29 |
| 1679170740 | Jennifer Lassiter | Nurse Practitioner | 4116 Holley Rd., Lizella, GA 31052 | 2020-10-02 |
| 1891301164 | Tashoy Wallace | Nurse Practitioner | 121 Odyssey Turn, Conyers, GA 30012-3681 | 2020-09-21 |
| 1912513672 | Katherine Anne Sego | Nurse Practitioner | 4060 Rolling Meadows Ln, Watkinsville, GA 30677-3011 | 2020-09-18 |
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1588276505 | Sherron Johnson | Nurse Practitioner | 1980 Wrights Way, Jonesboro, GA 30236-7205 | 2020-08-20 |
| 1942811682 | Ashlee Renee Mack | Nurse Practitioner | 116 Slate Cir, Savannah, GA 31419-9681 | 2020-08-16 |
| 1467063610 | Rosa Maria Phillips | Nurse Practitioner | 649 Amicalola Woods Rd, Dawsonville, GA 30534-1205 | 2020-08-12 |
| 1508476581 | Jarvis Reese | Nurse Practitioner | 413 Tug Ct, Warner Robins, GA 31088-2134 | 2020-08-05 |
| 1750991790 | Akosua Frema Sarfo | Nurse Practitioner | 116 Ginkgo Ln, Grovetown, GA 30813-5392 | 2020-08-04 |
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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.