KRISTIN BRAVENEC JACKSON (NPI# 1215308143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215308143 |
| Entity Type | Individual |
| Full Name | KRISTIN BRAVENEC JACKSON |
| Other Name | KRISTIN BRAVENEC |
| Credential | FNP |
| Practice Address |
100 Medical Dr Lake Jackson TX 77566-5674 |
| Practice Telephone | 9792851170 |
| Mailing Telephone | 9792851170 |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2018-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP130196 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497398697 | Kristin Burch Jackson | Physical Therapist | 317 Wallace Ave Ste 203, Louisville, KY 40207-3060 | 2019-10-21 |
| 1689221277 | Kristin L Jackson | Physical Therapy Assistant | 15820 Addison Rd, Addison, TX 75001-3549 | 2019-08-20 |
| 1104255116 | Kristin Mary Jackson | Psychologist | 410 N Prince St, Lancaster, PA 17603-3010 | 2013-11-11 |
| 1740578707 | Kristin Ann Monnat Jackson | Nurse Anesthetist, Certified Registered | 1236 E Elizabeth St, Suite 1, Fort Collins, CO 80524-4000 | 2011-07-12 |
| 1174616825 | Kristin M Jackson | Dentist | 45 N Madison Ave, Greenwood, IN 46142-3526 | 2006-10-02 |
| 1861417859 | Kristin M. Jackson | Obstetrics & Gynecology | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-07-12 |
| 1720037724 | Kristin Jackson | Podiatrist | 1108 1st St Se, Little Falls, MN 56345-3440 | 2006-05-08 |
| Street Address |
100 MEDICAL DR |
| City | LAKE JACKSON |
| State | TX |
| Zip Code | 77566-5674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316497381 | U S Anesthesia Partners of Texas | Anesthesiology | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2016-10-13 |
| 1588118194 | Brian Chang | Nurse Practitioner | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2016-08-11 |
| 1720441561 | Anthonia Ada Abanobi | Nurse Practitioner | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2016-03-30 |
| 1366814089 | Astral Emergency Physicians, Pllc | Physician Assistant | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2015-10-21 |
| 1295106201 | Rhapsody Emergency Physicians, Pplc | Physician Assistant | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2015-10-16 |
| 1336520113 | Tasha Chaoman | Nurse Practitioner | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2015-06-17 |
| 1457757890 | Joshua Roszak | Physician Assistant | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2014-11-12 |
| 1013321819 | Laura Day Ellender | Nurse Practitioner | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2014-06-19 |
| 1083034771 | Ruchita Patel | Family Medicine | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2014-04-21 |
| 1285063776 | A. Mohammad Khan, Md | Skilled Nursing Facility | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2013-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588271746 | Daniel Kent | Pharmacist | 121 Tx-332 W, Lake Jackson, TX 77566 | 2020-09-30 |
| 1134692403 | Gulf Coast Gastroenterology Lab | Clinical Medical Laboratory | 219 Oak Drive South, Suite A, Lake Jackson, TX 77566 | 2019-01-09 |
| 1194266288 | Kaitlin Dingee | Nurse Practitioner | 208 Oak Dr S Ste 502, Lake Jackson, TX 77566 | 2017-03-09 |
| 1326581935 | Nec Lake Jackson Emergency Center, Lp | Clinic/Center | 103 Winding Way, Lake Jackson, TX 77566 | 2016-11-30 |
| 1548618911 | Sara Eddy | Counselor | 109 Circle Way, Lake Jackson, TX 77566 | 2016-05-26 |
| 1689020158 | Baker Chiropractic Center Pllc | Chiropractor | 100-a Plantation Drive, Lake Jackson, TX 77566 | 2016-05-13 |
| 1326409368 | Janet Chen | Pharmacist | 131 Oyster Creek Dr., Lake Jackson, TX 77566 | 2016-03-18 |
| 1164819488 | Eco Dental Care, Pllc | Dentist | 210 Lake Rd, Ste 800 A, Lake Jackson, TX 77566 | 2015-04-24 |
| 1730578196 | Anna Katherine Tucker | Occupational Therapy Assistant | 1052 Cardinal Dr, Richwood, TX 77566 | 2015-01-22 |
| 1306243035 | H-e-b, Lp | Clinical Medical Laboratory | 97 Oyster Creek Drive, Lake Jackson, TX 77566 | 2014-11-24 |
| Find all providers in zip 77566 | ||||
| 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 |
|---|---|---|---|---|
| 1285046490 | Yu Eun Hwang | Nurse Practitioner | 109 Parking Way St, Lake Jackson, TX 77566-5228 | 2014-05-21 |
| 1396009015 | Heidi M Mansy | Nurse Practitioner | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2012-06-27 |
| 1699823344 | Megan Renee Medina | Nurse Practitioner | 100 Medical Dr, Lake Jackson, TX 77566-5674 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306245 | Julie Gunnarson | Nurse Practitioner | 435 Tioga St, Burleson, TX 76028-8197 | 2020-11-03 |
| 1033710488 | Angela Renee Aston | Nurse Practitioner | 805 Kelly Creek, Bulverde, TX 78163 | 2020-11-03 |
| 1629678347 | Prime Telecare LLC | Nurse Practitioner | 2251 Bagdad Rd Unit 102, Cedar Park, TX 78613-6521 | 2020-10-30 |
| 1063012508 | Kelsey Jean Reisch | Nurse Practitioner | 5001 Orleans Cir, Rowlett, TX 75088-6175 | 2020-10-26 |
| 1124628557 | Jessica Buchanan | Nurse Practitioner | 212 Sheridan Loop, Belton, TX 76513-8024 | 2020-10-26 |
| 1811596323 | Rachel Christine Jarrell | Nurse Practitioner | 10080 Research Forest Dr, The Woodlands, TX 77354-6780 | 2020-10-26 |
| 1356940837 | Katherine Anna Nack | Nurse Practitioner | 6100 Harris Pkwy Ste 285, Fort Worth, TX 76132-4127 | 2020-10-26 |
| 1558960104 | Suzette Roberts | Nurse Practitioner | 2505 Pebble Lodge Ln, Friendswood, TX 77546-5587 | 2020-10-23 |
| 1982203675 | Ilse Deyanire Trevino | Nurse Practitioner | 6233 Tepepan Dr, Brownsville, TX 78521-7135 | 2020-10-22 |
| 1629677612 | Laurel Sunde | Nurse Practitioner | 11111 Research Blvd-ll2, Austin, TX 78759 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | LAKE JACKSON |
| Zip Code | 77566 |
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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.