EVELYN NICOLE JACKSON (NPI# 1568961837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568961837 |
| Entity Type | Individual |
| Full Name | EVELYN NICOLE JACKSON |
| Practice Address |
36 Pemberton Cv Jackson TN 38305 |
| Mailing Address |
497 Little Rd Martin TN 38237-5440 |
| Practice Telephone | 7313941145 |
| Practice Fax Number | 8443740233 |
| Mailing Telephone | 7315141707 |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
23714 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 497 Little Rd, Martin, TN 382375440 | 7315141707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275625568 | Evelyn Jackson | Military Health Care Provider | 209 Miller Loop, Fort Benning, Columbus, GA 31905-6560 | 2006-09-28 |
| 1457330821 | Evelyn Jackson | Nurse Anesthetist, Certified Registered | 5898 Augusta Ln, Grand Blanc, MI 48439-9472 | 2006-01-12 |
| 1770707093 | Evelyn Diane Jackson | Internal Medicine | 3416 Olandwood Ct, Suite 200, Olney, MD 20832-1372 | 2007-04-11 |
| 1326197690 | Evelyn K. Jackson | Nurse Practitioner | 6565 Fannin St, Stb 1160, Houston, TX 77030-2703 | 2007-01-09 |
| Street Address |
36 PEMBERTON CV |
| City | JACKSON |
| State | TN |
| Zip Code | 38305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346643087 | Sheila Carlton | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305 | 2014-10-08 |
| 1013572502 | Stephanie Pool | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305-5514 | 2019-05-09 |
| 1922469543 | Ultra Health LLC | Internal Medicine | 36 Pemberton Cv, Jackson, TN 38305 | 2016-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113627 | Jessicah Blasdel | Nurse Practitioner | 113 W Michigan Ave, Jackson, MI 49201-1340 | 2020-10-31 |
| 1801406335 | Jade Russell | Nurse Practitioner | 2205 W Morrell St, Jackson, MI 49203-1357 | 2020-08-10 |
| 1992315212 | Patrecia Campbell | Nurse Practitioner | 2570 Bailey Ave Ste 7, Jackson, MS 39213-6905 | 2020-08-01 |
| 1669008926 | Kristine Edwards | Nurse Practitioner | 723 Woodlawn Ave, Jackson, MI 49203-2921 | 2020-03-19 |
| 1295366391 | Christy White | Nurse Practitioner | 363 Old Pinson Rd, Jackson, TN 38301-9576 | 2020-01-28 |
| 1972141620 | Primary Care - Bemis, LLC | Nurse Practitioner | 1385 S Highland Ave Ste B4, Jackson, TN 38301-7547 | 2019-12-12 |
| 1174164263 | Tami Anne Miller | Nurse Practitioner | 124 N Bast St, Jackson, MO 63755-1704 | 2019-10-01 |
| 1265080584 | Cameron Nicole Howard | Nurse Practitioner | 1860 Chadwick Dr Ste 256, Jackson, MS 39204-3486 | 2019-08-29 |
| 1831750843 | Rhiannon Michelle Andresen | Nurse Practitioner | 1022 Greystone Sq, Jackson, TN 38305-3580 | 2019-06-21 |
| 1902376361 | Jenay B Krumm | Nurse Practitioner | 1201 E Michigan Ave Ste 200, Jackson, MI 49201-1855 | 2018-11-28 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on EVELYN NICOLE 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.