Individual provider · Type 1 NPI
Nicole Jackson, FNP, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Dover, DE
NPI number
1366974628
Active
Practice location
200 Banning St Ste 260
Dover, DE 19904-3489
Fax (302) 224-1402
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | LG0001029 (DE) |
| Family Nurse Practitioner | 363LF0000X | LG0001029 (DE) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | L80010226 (DE) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1366974628
Nicole Jackson, FNP, PMHNP's National Provider Identifier is 1366974628, issued on Mar 28, 2017. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Dover, DE. The record was last updated on Feb 20, 2023.