Individual provider · Type 1 NPI
Tiffany Jackson
Psychiatric/Mental Health Nurse Practitioner · Southaven, MS
NPI number
1124762794
Active
Practice location
5875 Landau Dr
Southaven, MS 38671-8946
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 71016838A (IN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1124762794
Tiffany Jackson's National Provider Identifier is 1124762794, issued on Apr 20, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Southaven, MS. The record was last updated on Sep 28, 2026.