JASMINE SHANAE JACKSON


Address: 3400 S Crater Rd Ste B, Petersburg, VA 23805
Phone: 8047336960

JASMINE SHANAE JACKSON (NPI# 1578112496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578112496
Entity Type Individual
Full Name JASMINE SHANAE JACKSON
Credential NP
Practice Address 3400 S Crater Rd Ste B
Petersburg
VA 23805
Mailing Address 3400 S Crater Rd Ste B
Petersburg
VA 23805-9252
Practice Telephone 8047336960
Mailing Telephone 8047336960
Enumeration Date 2019-09-04
Last Update Date 2019-09-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
0024178156 VA Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
9000 Staples Mill Rd, Henrico, VA 232282021 8049779526

Other Providers JASMINE JACKSON

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1821613571 Jasmine E Jackson Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3165 Overton Crossing St, Memphis, TN 38127-6522 2020-06-09
1902220569 Jasmine Jackson Counselor 901 Us Highway 68 Ste 900, Maysville, KY 41056-9190 2014-02-18
1922358738 Jasmine L Jackson Rehabilitation Practitioner 1385 European Dr, Henderson, NV 89052-4021 2012-09-19
1912133398 Jasmine Nicole Jackson Licensed Practical Nurse 1730 Kensington Dr, Dayton, OH 45406-3912 2009-05-30
1952576753 Jasmine Jackson Chiropractor 1105 N Dutton Ave, Suite D, Santa Rosa, CA 95401-4682 2008-04-23
1376019414 Jasmine Deloris Jackson Counselor 1902 2nd Ave, Seattle, WA 98101-1155 2018-10-16
1902399785 Jasmine Keara Jackson Counselor 2800 Youree Dr Ste 482, Shreveport, LA 71104-3666 2018-06-07
1154869048 Jasmine Gabrielle Jackson Physical Therapist 4321 Hartwick Rd Ste 101, College Park, MD 20740-3201 2017-02-10
1912443367 Jasmine Marie Jackson Case Manager/Care Coordinator 601 W 26th St Rm 522, New York, NY 10001-1137 2017-01-10
1336500255 Jasmine Jackson Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S, Bronx, NY 10461-1138 2016-03-20

Office Location

Street Address 3400 S CRATER RD STE B
City PETERSBURG
State VA
Zip Code 23805

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780081059 Belen Nunez Internal Medicine 3400 S Crater Rd Ste B, Petersburg, VA 23805-9252 2014-12-02
1407231152 Hasan Iftikhar Internal Medicine 3400 S Crater Rd Ste B, Petersburg, VA 23805-9252 2015-07-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134690647 Miles Viant Occupational Therapist 287 E Blvd, Petersburg, VA 23805 2018-12-10
1245756964 Dexter Shabazz Lett Registered Nurse 10543 S. Crater Rd, S. Prince George, VA 23805 2017-08-15
1891145876 Taylor Enhanced Living Counselor 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 2016-06-21
1700255205 Ina Thompson Counselor 272 Medical Park Boulevard, Petersburg, VA 23805 2015-09-15
1932582541 Valeria Edda Madrid Malo Bohorquez Internal Medicine 50 Medical Park Blvd Ste C, Petersburg, VA 23805 2015-06-30
1548642788 Justin Andrew Phillingane Podiatrist 3335 S Crater Rd Ste 500, Petersburg, VA 23805 2015-06-24
1225417082 Paladin Dermatology LLC Nurse Practitioner 44 A& B Medical Park Blvd, Petersburg, VA 23805 2015-05-27
1245652544 Family Services Inc. Health Maintenance Organization 1045 Gustavo Lane, Petersburg, VA 23805 2014-01-06
1619268075 Charlene Belangia Massage Therapist 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 2011-04-20
1760709638 Caresouth Hha Holdings of Virginia, LLC Home Health 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 2010-04-30
Find all providers in zip 23805

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396342895 Stacey Reynolds Dahl Nurse Practitioner 103 Fram Treet, Petersburg, AK 99833-0589 2020-10-07
1992269286 Angela Hooe Nurse Practitioner 601 Old Wagner Rd Ste 100, Petersburg, VA 23805-9313 2019-01-30
1902390982 Haneefah Omega Henry Rhodes Nurse Practitioner Vsu Health Center 1 Hayden Dr, Petersburg, VA 23806-0001 2018-06-21
1265936454 Angela Marie Jeter Nurse Practitioner 3471 Woolper Rd, Petersburg, KY 41080-9764 2018-03-21
1205347846 Bethany Kinney Nurse Practitioner 4100 W Rauch Rd, Petersburg, MI 49270-9800 2017-10-23
1801244165 Tonya Shah Nurse Practitioner 601 Old Wagner Rd Ste 101, Petersburg, VA 23805-9313 2016-05-27
1801146071 Melissa Lee Mathias Nurse Practitioner 10 Mulligan Drive, Petersburg, WV 26847-1511 2012-09-14
1548411879 Lynette Galloway Branch Nurse Practitioner Virginia State University Student Health, 1 Hayden Drive, Petersburg, VA 23806-0001 2008-10-06
1922215128 Vicky Nell Groce Nurse Practitioner 212 South Public Square, Petersburg, TN 37144-0093 2007-05-17
1134298995 Becky J Calhoun Harman Nurse Practitioner 100 Hospital Dr Ste 1, Petersburg, WV 26847 2006-11-07
Find all providers in PETERSBURG

Competitor

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City PETERSBURG
Zip Code 23805

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Dataset Information

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.

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