JENNIFER JACKSON (NPI# 1518273499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518273499 |
| Entity Type | Individual |
| Full Name | JENNIFER JACKSON |
| Credential | NP |
| Practice Address |
1110 Broad Ave Ste 700 Gulfport MS 39501-8907 |
| Mailing Address |
Po Box 1810 Gulfport MS 39502-1810 |
| Practice Telephone | 2288674580 |
| Practice Fax Number | 2288674708 |
| Mailing Telephone | 2288674580 |
| Mailing Fax Number | 2288674708 |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2014-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R859293 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386738 | Jennifer O Jackson | Pharmacist | 1900 Ese Loop323, Tyler, TX 75701-8337 | 2020-11-05 |
| 1326655705 | Jennifer Nicole Jackson | Physical Therapy Assistant | 2540 Ridgeview Rd, Paris, TX 75460-3321 | 2020-09-29 |
| 1407461163 | Jennifer Jackson | Specialist/Technologist | 149 Flagstaff Dr, Bolingbrook, IL 60440-2657 | 2020-09-10 |
| 1689294829 | Jennifer K Jackson | Dietitian, Registered | 13017 Bear Dancer Trl Ne, Albuquerque, NM 87112-3726 | 2020-04-17 |
| 1285261479 | Jennifer Elizabeth Jackson | Pharmacist | 4675 W 37th Ave Apt 202, Denver, CO 80212-2079 | 2020-03-26 |
| 1487290524 | Jennifer Carol Jackson | Counselor | 76 Vassar St, Worcester, MA 01602-1535 | 2019-11-25 |
| 1275959348 | Jennifer Jackson | Dietitian, Registered | 101 Vinemont Dr, Lafayette, LA 70501-6579 | 2014-03-12 |
| 1013332535 | Jennifer Jackson | Speech-Language Pathologist | 1105 Mcmurdo Cir, Castle Rock, CO 80108-2821 | 2014-02-19 |
| 1891053526 | Jennifer Dawn Jackson | Counselor | 240 Orville Bates Ln, Estill Springs, TN 37330-4278 | 2012-05-01 |
| 1205149382 | Jennifer Lynn Lawrence Jackson | Pharmacist | 4718 Limestone Rd, Wilmington, DE 19808-1928 | 2010-07-19 |
| Street Address |
1110 BROAD AVE STE 700 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-8907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063452639 | Thomas Blanks | Internal Medicine | 1110 Broad Ave, Suite 700, Gulfport, MS 39501-8907 | 2006-06-08 |
| 1538532221 | Diabetes Clinic of The Coast, Pllc | Nurse Practitioner | 1110 Broad Ave, Suite 600, Gulfport, MS 39501-8907 | 2015-11-04 |
| 1548677396 | Madison Davis | Dietitian, Registered | 1110 Broad Ave, Suite 500, Gulfport, MS 39501-8907 | 2014-07-14 |
| 1912331182 | Kelsey J. Lingsch | Dietitian, Registered | 1110 Broad Ave, Suite 600, Gulfport, MS 39501-8907 | 2013-08-24 |
| 1770826380 | Kristin Sessums | Dietitian, Registered | 1110 Broad Ave, Suite 500, Gulfport, MS 39501-8907 | 2013-04-02 |
| 1609198290 | Atlantic Ob/gyn, Inc | Specialist | 1110 Broad Ave, Suite 100, Gulfport, MS 39501-8907 | 2010-02-23 |
| 1063744704 | Memorial Hospital At Gulfport | Internal Medicine | 1110 Broad Ave, Suite 700, Gulfport, MS 39501-8907 | 2010-02-05 |
| 1417191222 | Lainie J Jorns | Family Medicine | 1110 Broad Ave, Suite 700, Gulfport, MS 39501 | 2009-04-23 |
| 1942466842 | Richa Gupta | Internal Medicine | 1110 Broad Ave, Suite 500, Gulfport, MS 39501-8907 | 2008-07-31 |
| 1922269216 | Memorial Hospital At Gulfport | Internal Medicine | 1110 Broad Ave, Suite 700, Gulfport, MS 39501-8907 | 2008-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1063033108 | Tiffany Reffit | Nurse Practitioner | 4300 15th St Ste B, Gulfport, MS 39501-2524 | 2020-04-29 |
| 1669002333 | Lauren Renee Meaut | Nurse Practitioner | 1391 Broad Ave Ste 320, Gulfport, MS 39501-2419 | 2020-01-22 |
| 1871132076 | Meddol Regina Mccray | Nurse Practitioner | 2070 30th St, Gulfport, MS 39501-6055 | 2020-01-06 |
| 1154968394 | Carolyn Marie Peters | Nurse Practitioner | 10236 Little Gem Dr, Gulfport, MS 39503-8357 | 2019-12-06 |
| 1588121578 | Mai Thi Tran | Nurse Practitioner | 1404 44th Ave, Gulfport, MS 39501-2554 | 2019-02-26 |
| 1861957631 | Tomika Marie Dedeaux | Nurse Practitioner | 283 Debuys Rd, Gulfport, MS 39507-2800 | 2019-02-06 |
| 1861963993 | Carol Leigh Anne Thompson | Nurse Practitioner | 2449 Summerwood, Gulfport, MS 39507-2216 | 2018-12-16 |
| 1730679739 | Erica Lynn Turan | Nurse Practitioner | 3310 17th St, Gulfport, MS 39501-3915 | 2018-05-15 |
| 1740709773 | Justine Hunt | Nurse Practitioner | 8950 Lorraine Rd Ste B, Gulfport, MS 39503-4183 | 2017-09-11 |
| Find all providers in GULFPORT | ||||
Please comment or provide details below to improve the information on JENNIFER JACKSON.
| 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.