Andrea Delois Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95012994 Issued in CA

Practice address

1114 W 6TH St
Hanford, CA 93230-4901

Phone

(559) 582-0397

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1154970846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 W 6TH ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932304901",
            "telephone_number": "559-582-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W 6TH ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932304901",
            "telephone_number": "559-582-0397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1212 Hanna Ave",
            "address_purpose": "LOCATION",
            "city": "Corcoran",
            "state": "CA",
            "postal_code": "932122313",
            "country_code": "US",
            "telephone_number": "559-992-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDREA",
        "middle_name": "DELOIS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95012994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hanford, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.