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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024178156 | VA | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
9000 Staples Mill Rd, Henrico, VA 232282021 | 8049779526 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
Street Address |
3400 S CRATER RD STE B |
City | PETERSBURG |
State | VA |
Zip Code | 23805 |
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 |
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 Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
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 |
City | PETERSBURG |
Zip Code | 23805 |
Please comment or provide details below to improve the information on JASMINE SHANAE 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.