Michelle Jackson, MSN, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN0000028120 Issued in TN

Practice address

739 S Maple Ave
Cookeville, TN 38501-4056

Phone

(931) 397-3851

NPI assigned

Jun 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1336715333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 S MAPLE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014056",
            "telephone_number": "931-397-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 S MAPLE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014056",
            "telephone_number": "931-397-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000028120",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000028120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terah C Isaacson, M.D.
• Isd Renal Inc
• Itzsebbyyy LLC
• George L Ivey III, M.D.
• Kristi Michelle Jackson, MA, LPC-MHSP
• Nevia Jackson
• Robin Jacob, MD
• Cierra Jacobson
• Jacquelyn Jacobson, LCSW
• Natalie Chavi Jain, MPH, PA-S

• Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.