NICOLE JACKSON (NPI# 1366974628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366974628 |
| Entity Type | Individual |
| Full Name | NICOLE JACKSON |
| Credential | FNP |
| Practice Address |
1020 Forrest Ave Dover DE 19904-2799 |
| Mailing Address |
1020 Forrest Ave Dover DE 19904 |
| Practice Telephone | 3026522455 |
| Practice Fax Number | 3023226251 |
| Mailing Telephone | 3026522455 |
| Mailing Fax Number | 3023226251 |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2019-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | LG0001029 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
LG0001029 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2 Penns Way, Suite 412, New Castle, DE 19720 | 3026522455 | 3023226251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699184689 | Nicole Jackson | Specialist | 3983 Thunder Heights Ln, Middleburg, FL 32068-7362 | 2014-08-05 |
| 1053745521 | Nicole L Jackson | Counselor | 3394 Mckelvey Rd Ste 116, Bridgeton, MO 63044-2531 | 2013-09-02 |
| 1245569276 | Nicole Denise Jackson | Licensed Practical Nurse | 2122 Ridge Rd W, Rochester, NY 14626-2802 | 2009-12-22 |
| 1144559931 | Nicole L Jackson | Licensed Practical Nurse | 18680 Main Street, Tontogany, OH 43565 | 2009-12-08 |
| 1144489261 | Nicole L. Jackson | Counselor | 6815 W Capitol Dr Ste 304, Milwaukee, WI 53216-2056 | 2008-06-04 |
| 1124299680 | Nicole Jackson | Licensed Practical Nurse | 1830 Southern Pkwy, Springfield, OH 45506-3115 | 2008-03-12 |
| 1578740023 | Nicole Jackson | Counselor | 3630 George Washington Hwy, Ste B-6, Yorktown, VA 23693 | 2008-01-28 |
| 1205999588 | Nicole Lewis Jackson | Dentist | 3298 Northside Dr, Macon, GA 31210 | 2006-12-18 |
| 1104447275 | Nicole Feliz Jackson | Specialist/Technologist | 1301 S Us Highway 377, Argyle, TX 76226-7744 | 2020-04-30 |
| 1023637220 | Nicole Jackson | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-04-09 |
| Street Address |
1020 FORREST AVE |
| City | DOVER |
| State | DE |
| Zip Code | 19904-2799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184699126 | Roger William Kane Jr. | Dentist | 1020 Forrest Ave, Dover, DE 19904 | 2006-02-22 |
| 1568007755 | Erica Patosky | Nurse Practitioner | 1020 Forrest Ave, Dover, DE 19904-2799 | 2019-11-11 |
| 1912416009 | Joseph Adam Mitchell | Nurse Practitioner | 1020 Forrest Ave, Dover, DE 19904-2799 | 2017-09-21 |
| 1326425430 | Eunice Afuah Amoako | Family Medicine | 1020 Forrest Ave, Dover, DE 19904-2799 | 2015-04-28 |
| 1942545587 | Jennifer Osei-afriyie | Nurse Practitioner | 1020 Forrest Ave, Dover, DE 19904-2799 | 2012-12-09 |
| 1407163983 | Jennifer Ann Bader | Emergency Medical Technician, Basic | 1020 Forrest Ave, Suite 1, Dover, DE 19904-2799 | 2010-09-07 |
| 1821220732 | Laurie M Shrader | Dietitian, Registered | 1020 Forrest Ave, Dover, DE 19904-2799 | 2009-08-12 |
| 1134363211 | Monty Leone Health Works Inc | Emergency Medicine | 1020 Forrest Ave, Suite 1, Dover, DE 19904 | 2009-04-21 |
| 1770765448 | Elizabeth Reetz | Family Medicine | 1020 Forrest Ave, Dover, DE 19904 | 2007-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534318 | Stanford Community Development Corporation, Inc | Community Health Worker | 111 South West Street, Suite 5, Dover, DE 19904 | 2020-10-02 |
| 1770145120 | Cara May O'reilly | Nurse Practitioner | 540 S. Governors Ave, Ste 101a, Dover, DE 19904 | 2019-07-07 |
| 1639631716 | Victoria Louise Sisson | Physical Therapy Assistant | 301 South Banning Street, Dover, DE 19904 | 2019-04-05 |
| 1336603091 | Ashley Santana | Counselor | 32 West Lookerman Street, Suite #103, Dover, DE 19904 | 2019-01-28 |
| 1679059869 | Vicdania Home Services | Technician | 1019 South Govenors Avenue, Dover, DE 19904 | 2018-07-11 |
| 1295221372 | Pam Squared At Dover LLC | Rehabilitation Hospital | 1240 Mckee Road, Dover, DE 19904 | 2018-07-02 |
| 1871000869 | Ronald Allen Beard | Counselor | 44 Carver Road, Dover, DE 19904 | 2017-12-29 |
| 1508376518 | First State Orthopaedics, Pa | Orthopaedic Surgery | 285 Beiser Blvd, Ste 201, Dover, DE 19904 | 2017-10-04 |
| 1700325057 | Center At Eden Hill LLC | Skilled Nursing Facility | 300 Banning Street, Dover, DE 19904 | 2017-02-20 |
| 1811352826 | West Dover Dental, LLC | Dentist | 2 Greentree Drive, Dover, DE 19904 | 2015-12-17 |
| Find all providers in zip 19904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205436300 | Constance Crane | Nurse Practitioner | 1711 Windswept Ct, Dover, DE 19901-5854 | 2020-10-28 |
| 1649870627 | Anita L Tyndall | Nurse Practitioner | 200 Banning St Ste 250, Dover, DE 19904-3492 | 2020-10-28 |
| 1013523422 | Mood Clinic Pllc | Nurse Practitioner | 56 Durham Rd Unit 54, Dover, NH 03820-4478 | 2020-09-21 |
| 1023631504 | Emily Reneker | Nurse Practitioner | 314 E 13th St, Dover, OH 44622-1126 | 2020-05-19 |
| 1295362333 | Melanie L Sciarra | Nurse Practitioner | 125 Greentree Dr Ste 1, Dover, DE 19904-7656 | 2020-03-26 |
| 1023655842 | Reny Varghese | Nurse Practitioner | 1225 Walker Rd # 6541, Dover, DE 19904-6541 | 2019-12-01 |
| 1205488988 | Sarah A Walsh | Nurse Practitioner | 17 Old Rollinsford Rd Ste 5, Dover, NH 03820-2821 | 2019-07-12 |
| 1891266250 | Misty Renee May | Nurse Practitioner | 1114 S Dupont Hwy Ste 104, Dover, DE 19901-4401 | 2018-12-11 |
| 1225508377 | Rosa Ann Cleaver | Nurse Practitioner | 205 Medical Park Drive, Dover, OH 44622 | 2018-12-03 |
| 1043761372 | Amber Dunlap-ott | Nurse Practitioner | 927 Chelsea Dr, Dover, OH 44622-1504 | 2016-10-21 |
| Find all providers in DOVER | ||||
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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.