MS. ANGELIQUE MECHELLE JACKSON (NPI# 1144599366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144599366 |
| Entity Type | Individual |
| Full Name | MS. ANGELIQUE MECHELLE JACKSON |
| Credential | RN, APN-BC |
| Practice Address |
1410 Trotwood Ave Columbia TN 38401-4901 |
| Mailing Address |
3425 Maple Timber Dr Antioch TN 37013-5453 |
| Practice Telephone | 6787547728 |
| Mailing Telephone | 6787547728 |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2014-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16345 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871058602 | Angelique Jackson | Registered Nurse | 2376 Carlford Street, Columbus, OH 43232 | 2019-02-06 |
| Street Address |
1410 TROTWOOD AVE |
| City | COLUMBIA |
| State | TN |
| Zip Code | 38401-4901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336172873 | Hqm of Columbia, LLC | Nursing Facility/Intermediate Care Facility | 1410 Trotwood Ave, Columbia, TN 38401-4901 | 2006-07-08 |
| 1760979371 | Columbia Tn Snf LLC | Skilled Nursing Facility | 1410 Trotwood Ave, Columbia, TN 38401 | 2018-04-18 |
| 1942686746 | Emily Megan Mitchell | Nurse Practitioner | 1410 Trotwood Ave, Columbia, TN 38401-4901 | 2015-08-04 |
| 1326213778 | Polly Floyd | Physical Therapy Assistant | 1410 Trotwood Ave, Columbia, TN 38401-4901 | 2008-04-28 |
| 1073704367 | Lp Columbia LLC | Skilled Nursing Facility | 1410 Trotwood Ave, Columbia, TN 38401-4901 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327629 | Andrew Swensen | Pharmacist | 1202 South James Campbell Blvd, Columbia, TN 38401 | 2020-08-17 |
| 1790305522 | Milaya L Webster | Community Based Residential Treatment Facility, Mental Illness | 809 South Water Streer, Columbia, TN 38401 | 2020-04-22 |
| 1730729468 | Dania Cortez | Licensed Practical Nurse | 40 Park Plus Court, Columbia, TN 38401 | 2020-01-10 |
| 1619519683 | Agilitas Usa, Inc | Clinic/Center | 627 S. James Campbell Blvd., Suite B, Columbia, TN 38401 | 2019-10-11 |
| 1710531280 | Abby Graves | Dietitian, Registered | 1216 Trottwood Ave, Columbia, TN 38401 | 2019-08-01 |
| 1942771746 | James Brian Gregory | Marriage & Family Therapist | 497 E James Campbell Blvd, Columbia, TN 38401 | 2018-12-06 |
| 1104312255 | Sarah Miller | Social Worker | 230 E James Campbell Boulevard, Suite 113, Columbia, TN 38401 | 2018-07-02 |
| 1407343148 | Tammy Lynn James | Nurse Practitioner | 6011 Trotwood Ave Ste D, Columbia, TN 38401 | 2018-04-18 |
| 1053838276 | Tiffany Huskey | Audiologist-Hearing Aid Fitter | 1202 S James Campbell Blvd, Suite 15, Columbia, TN 38401 | 2017-08-28 |
| 1942726963 | Northland Hearing Center, Inc. | Hearing Aid Equipment | 1202 South James Campbell Blvd, Suite 15, Columbia, TN 38401 | 2017-08-22 |
| Find all providers in zip 38401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114526266 | Leslie Desha | Nurse Practitioner | 1109 Pheasant Run, Columbia, MO 65201-6253 | 2020-10-20 |
| 1407454101 | Jason D Jones | Nurse Practitioner | 213 Austell Dr, Columbia, TN 38401-5531 | 2020-10-14 |
| 1316544315 | Rezvaneh Goodarzi | Nurse Practitioner | 8830 Tamar Dr Apt 301, Columbia, MD 21045-2962 | 2020-10-03 |
| 1316559255 | Lauren Olivia Lenauer | Nurse Practitioner | 1600 E Broadway # 300, Columbia, MO 65201-5844 | 2020-08-21 |
| 1285246272 | Lourdes Claire De Las Alas | Nurse Practitioner | 6005 Shepherd Sq, Columbia, MD 21044-3114 | 2020-08-20 |
| 1619587540 | Josey Abraham | Nurse Practitioner | 305 Aiken Hunt Cir, Columbia, SC 29223-8407 | 2020-08-05 |
| 1588274765 | Tomeka Nichole Jackson | Nurse Practitioner | 6156 Saint Andrews Rd Ste 208, Columbia, SC 29212-3147 | 2020-08-03 |
| 1528696762 | Mark Edward Merkel | Nurse Practitioner | 1040 N James M Campbell Blvd, Columbia, TN 38401-2756 | 2020-04-01 |
| 1306489265 | Andrew Leitch | Nurse Practitioner | 313 N Trenholm Rd, Columbia, SC 29206-3207 | 2019-10-23 |
| 1760033476 | Emily Smith | Nurse Practitioner | 157 Chinquapin Cir, Columbia, SC 29212-2902 | 2019-09-24 |
| Find all providers in COLUMBIA | ||||
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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.