Active NPI
Jenna Jackson, PHARM.D., R.PH.
- Pharmacist
- Mankato, MN
National Provider Identifier
1013786391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 126146
- Practice address
- 1025 Marsh St
Mankato, MN 56001-4752 - Phone
- (507) 594-2999
- NPI assigned
- Dec 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 126146 | MN | Primary |
Addresses
Primary practice location
1025 Marsh St
Mankato, MN 56001-4752
Mailing address
910 Patriot Dr Apt 208
Mankato, MN 56001-2857
Phone (612) 749-3915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126146 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1013786391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 PATRIOT DR APT 208",
"city": "MANKATO",
"state": "MN",
"postal_code": "560012857",
"telephone_number": "612-749-3915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560014752",
"telephone_number": "507-594-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JENNA",
"credential": "PHARM.D., R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-27",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "126146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.