Desmaine Jackson, RNC- OB

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

308665 Issued in NC

Practice address

1100 E Wendover Ave
Greensboro, NC 27405-6713

Phone

(336) 641-4694

NPI assigned

Feb 1, 2023

Last updated

Feb 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1639875685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056713",
            "telephone_number": "336-641-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056713",
            "telephone_number": "336-641-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DESMAINE",
        "credential": "RNC- OB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "NC",
            "license": "308665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley Jackson
• Carswell Hoots Jackson, MD
• Chelsea Nicole Jackson, FNP-C
• Christine L Jackson
• Delphia Dent Jackson, CNA
• Dominique Jackson
• Freeman R Jackson Jr., M.D.
• Freeman Randolph Jackson, M.D.
• Jerica Jackson
• Julie Jackson, SLP

• Ambulatory Women's Health Care Registered Nurse in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Ambulatory Women's Health Care Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.