Tanya Tamara Jackson, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R242369 Issued in GA

Practice address

968 Brookmere CT
Atlanta, GA 30349-6866

Phone

(470) 633-0313

NPI assigned

Apr 28, 2025

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1891583258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 BROOKMERE CT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303496866",
            "telephone_number": "470-633-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 BROOKMERE CT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303496866",
            "telephone_number": "470-633-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TANYA",
        "middle_name": "TAMARA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "R242369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Charisse Jackson, LMFT
• Stephane Lea Jackson, LMT, CCT
• Sunny Michele Jackson
• Taneisha Chree Jackson
• Tanjela M Jackson, MD
• Tara Jackson, M.ED.
• Taylor Jackson, DC
• Taylor Simone Jackson
• Tiphani Jackson, PT, DPT, ATC
• Todd Jackson Jr., MD, MPH

• Psychiatric/Mental Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.