Jennifer Jo Jackson, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

00115287 Issued in TN

Practice address

2865 E Main St
Humboldt, TN 38343-3070

Phone

(731) 377-5525

NPI assigned

Jan 5, 2024

Last updated

Jan 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1346010717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 TIPTON AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243328",
            "telephone_number": "731-377-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 E MAIN ST",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "383433070",
            "telephone_number": "731-377-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "JO",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "TN",
            "license": "00115287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humboldt Family Walk-in Clinic LLC
• Humboldt General Hospital
• Humboldt Healthcare and Rehab Center, LLC
• Humboldt Nursing Home, Inc.
• Bobbi Jean Jackson, PTA
• Jonathan Dale James
• Katherine Elizabeth James, FNP-C
• Kelly Napier Johnston, P.A.-C
• William B Jones, NP
• Yeo Seol Kang

• Nurse's Aide in Humboldt, TN
• Providers in Humboldt, TN by specialty
• Nurse's Aide in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.