Nancy R Jackson-Patterson, NURSE PRACTITIONER

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN177419 Issued in GA

Practice address

6211 Magnolia RDG
Stone Mountain, GA 30087-6070

Phone

(770) 298-0961

NPI assigned

Nov 2, 2020

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": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1366043887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 MAGNOLIA RDG",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876070",
            "telephone_number": "770-298-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 MAGNOLIA RDG",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876070",
            "telephone_number": "770-298-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-PATTERSON",
        "first_name": "NANCY",
        "middle_name": "R",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN177419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nneka Anuli Izundu, PHARM MD
• J & D Royal Care Elite LLC
• Jabezz LLC
• Daniel L Jack Jr., PT
• Jackson Solutions
• Kelsey Jackson
• Orville Jackson
• Shavonta Jackson, CNA
• Edil Jama
• Yussuf Jamaa

• Primary Care Nurse Practitioner in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.