MRS. LONDON TERI JACKSON (NPI# 1902416795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902416795 |
| Entity Type | Individual |
| Full Name | MRS. LONDON TERI JACKSON |
| Other Name | MISS LONDON TERI ROBERT |
| Credential | FNP-C |
| Practice Address |
405 S Main St Springville UT 84663-2252 |
| Practice Telephone | 8014912238 |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
8735023-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
405 S MAIN ST |
| City | SPRINGVILLE |
| State | UT |
| Zip Code | 84663-2252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114565280 | The Village Pantry #9 | Pharmacy | 405 S Main St, Springville, UT 84663-2252 | 2019-12-19 |
| 1003320821 | Larry T Prettyman | Pharmacist | 405 S Main St, Springville, UT 84663-2252 | 2017-12-01 |
| 1447436332 | Pace Healthcare, LLC | Nurse Practitioner | 405 S Main St, Springville, UT 84663-2252 | 2008-01-10 |
| 1558406181 | Village Pantry #9 | Pharmacy | 405 S Main St, Springville, UT 84663-2252 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1780215269 | Reboot Centers Hobble Creek | Clinical Neuropsychologist | 1154 Left Fork Hobble Creek Canyon Rd, Springville, UT 84663 | 2020-02-03 |
| 1063053866 | Jesus Lopez | Clinic/Center | 1461 Archmore Loop, Springville, UT 84663 | 2019-10-02 |
| 1689109506 | Cd Pharmacy LLC | Pharmacy | 863 W 450 S, Suite 201, Springville, UT 84663 | 2017-04-28 |
| 1215479225 | Jaydynn Cusworth | Behavior Technician | 692 S 2800 W Unit I 101, Springville, UT 84663 | 2016-11-08 |
| 1245699602 | Pamela Jamison | Speech-Language Pathologist | 1072 Wildflower Way, Springville, UT 84663 | 2016-02-14 |
| 1013397348 | Lindsay Erickson | Counselor | 470 Buckley Ave, Springville, UT 84663 | 2015-06-02 |
| 1790084903 | Grant Lee Murdoch | Counselor | 1102 N 850 W, Springville, UT 84663 | 2011-03-28 |
| 1306148739 | Siuta Sonny Faaootoa | Counselor | 551 North Main Street, Springville, UT 84663 | 2010-11-17 |
| 1891000790 | Christopher David Westover | Social Worker | 716 N 200 E, Springville, UT 84663 | 2010-08-16 |
| Find all providers in zip 84663 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609394758 | Emily G Dunn | Nurse Practitioner | 5 E 400 N, Springville, UT 84663-1347 | 2017-09-08 |
| 1790910891 | Mary Beth Martin | Nurse Practitioner | 480 Walker Dr, Springville, AL 35146-3250 | 2009-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235742016 | Luz Elena Reni | Nurse Practitioner | 593 Millcreek Way, Bountiful, UT 84010-3920 | 2020-08-31 |
| 1841803137 | Anywhere Care | Nurse Practitioner | 9980 S. 300 W. Suite 200, Sandy, UT 84070 | 2020-08-26 |
| 1356952840 | Sandra Robles | Nurse Practitioner | 6671 S Redwood Rd Ste 101, West Jordan, UT 84084-7489 | 2020-08-10 |
| 1265050660 | Dana Michelle Roach | Nurse Practitioner | 3435 E Pony Express Pkwy Ste 104, Eagle Mountain, UT 84005-5515 | 2020-07-12 |
| 1174141964 | Kaitlyn Miller Albrecht | Nurse Practitioner | 14094 S Candy Pull Dr, Draper, UT 84020-7511 | 2020-07-08 |
| 1700403540 | Brady Ardell Byington | Nurse Practitioner | 6654 Willow Creek Rd, Mountain Green, UT 84050-6810 | 2020-06-27 |
| 1528697950 | Meagan Mckean | Nurse Practitioner | 2486 E Newport Cir, Cottonwood Heights, UT 84121-5642 | 2020-04-07 |
| 1104487677 | Brandilyn Rolfe | Nurse Practitioner | 2629 Cottage Ct, Park City, UT 84098-8226 | 2019-06-25 |
| 1447819974 | Andrew Brice Heinecke | Nurse Practitioner | 6807 S 3200 W, West Jordan, UT 84084-1828 | 2019-06-09 |
| 1467977884 | Eden Family Care and Medical Aesthetics | Nurse Practitioner | 2612 N Highway 162, Eden, UT 84310-9745 | 2017-08-07 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGVILLE |
| Zip Code | 84663 |
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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.