Gabriella Jackson

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

RN651718 Issued in PA

Practice address

1601 Cherry St Ste 11484
Philadelphia, PA 19102-1312

Phone

(215) 255-7356

NPI assigned

Jul 25, 2018

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": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1922585678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST STE 11484",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021312",
            "telephone_number": "215-255-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST STE 11484",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021312",
            "telephone_number": "215-255-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GABRIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "PA",
            "license": "RN651718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donchelle Jackson
• Dvone Jackson, MD
• Elaine Jackson, LCPC
• Elijah Jagger Jackson, LCSW
• Fatima Jackson
• Gail M Jackson, MA
• Ikishia N Jackson, R.N
• Janeira Jackson
• Jennifer Ellis Jackson, MD
• Jessica Ray Jackson, M.D.

• Case Management Registered Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Case Management Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.