Krystal Jackson, APRN
Individual provider Active NPI Acute Care Nurse Practitioner · New Haven, CT
NPI 1497005011 · NPPES record last updated Aug 1, 2017
Key facts
- NPI
- 1497005011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 005078 (CT)
- Practice address
- 20 York St
New Haven, CT 06510-3220 - Phone
- (203) 688-2300
- NPI assigned
- Sep 11, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Interoperability endpoints
- kjackson13919@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 005078 | CT | Yes |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3220
Mailing address
282 Sunnydale Ave
Bristol, CT 06010
Phone (347) 610-4763
Other providers in New Haven, CT
- Claudia Jackson
- Da'Ja Jackson
- Elisha Jana Jackson
- Jessica Jackson
- Kamilah Jackson
- Rebekah Jackson
- Tabisha Jackson
- Tamiko V Jackson
- Van Rieves Jackson IV
- Andrea Jacobs-Stannard
All providers in New Haven, CT · Acute Care Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.