Payton Nicole Jackson, PHARMD
Individual provider Active NPI Pharmacist · Ranson, WV
NPI 1821828880 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1821828880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- IN0009860 (WV)
- Practice address
- 217 Oak Lee Dr
Ranson, WV 25438-4871 - Phone
- (304) 728-9041
- Fax
- (304) 725-2365
- NPI assigned
- Aug 5, 2024
- 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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IN0009860 | WV | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IN0009860 | WV | Yes |
Addresses
Primary practice location
217 Oak Lee Dr
Ranson, WV 25438-4871
Mailing address
211 Wide River Farm Dr
Harpers Ferry, WV 25425-4424
Phone (304) 820-8235
Other providers in Ranson, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. 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.