Jacklyn Jackson

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

4707101768 Issued in MI

Practice address

5303 S Cedar St
Lansing, MI 48911-3800

Phone

(517) 346-8019

NPI assigned

Feb 20, 2014

Last updated

Feb 20, 2014By 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": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1609291137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD STE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106821",
            "telephone_number": "517-346-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 S CEDAR ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489113800",
            "telephone_number": "517-346-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACKLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4707101768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cigne Jackson, AT, ATC
• Curtis Lee Jackson Jr.
• Elizabeth Jackson
• Emily Jackson, PT
• Immanuel Jackson, DO
• Lindsey Jackson, LLMSW
• Mackenzie Loren Jackson, MD
• Martez Jackson
• Tiffany Jackson
• Zarah Jackson, MA

• Psychiatric/Mental Health Registered Nurse in Lansing, MI
• Providers in Lansing, MI by specialty
• Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.