Sharonda Jackson
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Waveland, MS
NPI 1801779079 · NPPES record last updated Jul 28, 2025
Key facts
- NPI
- 1801779079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 907616 (MS)
- Practice address
- 192 Kacey LN
Waveland, MS 39576-2540 - Phone
- (228) 343-1945
- NPI assigned
- Jul 28, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 907616 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 907616 | MS | Yes |
Addresses
Primary practice location
192 Kacey LN
Waveland, MS 39576-2540
Mailing address
192 Kacey LN
Waveland, MS 39576-2540
Phone (228) 343-1945
Other providers in Waveland, MS
- Hayley Charmaine Ferrill
- Hancock Medical Health Services
- Elizabeth Holder
- Paula Fabian Hughes
- Thao Huynh
- Syd L Jones Sr.
- Donnell Juliette Landtroop
- Nga Le
- Rudy Letellier
- Desiree Lewis
All providers in Waveland, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2025. 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.