Individual provider · Type 1 NPI

Kimberly Marie Jackson, ACNPC-AG

Nurse Practitioner · Conway, SC

NPI number 1336682780 Active

Practice location

2376 Cypress Cir Ste 300
Conway, SC 29526-8995

Mailing address

210 Village Center Blvd Ste 140
Myrtle Beach, SC 29579-6706

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X20986 (SC)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1336682780

Kimberly Marie Jackson, ACNPC-AG's National Provider Identifier is 1336682780, issued on Dec 2, 2016. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Conway, SC. The record was last updated on Jul 20, 2022.