Individual provider · Type 1 NPI
Fredericka Jackson
Psychiatric/Mental Health Nurse Practitioner · Omaha, NE
NPI number
1457993750
Active
Practice location
4141 N 156th St Ste 202
Omaha, NE 68116-1427
Fax (402) 508-8771
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 112991 (NE) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 112991 (NE) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1457993750
Fredericka Jackson's National Provider Identifier is 1457993750, issued on Oct 8, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Omaha, NE. The record was last updated on Mar 23, 2026.