Paula Ann Jackson, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN.458126 Issued in OH

Practice address

3673 Atherstone Rd
Cleveland, OH 44121-1357

Phone

(216) 322-6169

NPI assigned

Aug 16, 2013

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": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1891128542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3673 ATHERSTONE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441211357",
            "telephone_number": "216-322-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3673 ATHERSTONE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441211357",
            "telephone_number": "216-322-6169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1085 Allston Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441212417",
            "country_code": "US",
            "telephone_number": "216-322-6169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAULA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.458126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Jackson
• Mimi Jackson
• Nijah Emani Jackson
• Ono Jackson
• Paris N Jackson
• Rayshoun Thomas Jackson
• Renee M Jackson
• Rhondala Jackson
• Richard Allen Jackson, RN,CRNFA
• Ronald L Jackson, QMHS BA CMS BA

• Registered Nurse in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.