Individual provider · Type 1 NPI

Kelly Nicole Jackson, FNP

Family Nurse Practitioner · Kingsport, TN

NPI number 1306505854 Active

Practice location

4 Sheridan Sq Ste 102
Kingsport, TN 37660-7435

Fax (423) 588-7141

Mailing address

6016 Brookvale Ln Ste 200
Knoxville, TN 37919-4092

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X30680 (TN)

Family Nurse Practitioner: Definition to come...

6 other providers at this address

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About NPI 1306505854

Kelly Nicole Jackson, FNP's National Provider Identifier is 1306505854, issued on Dec 13, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Kingsport, TN. The record was last updated on May 21, 2026.