KATHLEEN J JACKSON, RN-APN, Family TAOS, NM

Contact Information

KATHLEEN J JACKSON, RN-APN

1331 MAESTAS RD
TAOS, NM 87571-6268

Phone: 575-776-7806
Fax: 575-224-3348
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Family	363LF0000X	50	Nurse Practitioner
Adult Health	363LA2200X	50	Nurse Practitioner
Nurse Practitioner	363L00000X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for KATHLEEN J JACKSON · (Female)

NPI Number	`1073619037`
Status	Active
Credentials	RN-APN
Entity	Individual
Enumeration date	09/16/2006
Last updated	04/24/2026 - About 1 months ago
Sole proprietor ¹	No
Identifiers	NJ License # 26NN06425500 PA License # TP001754C NJ Medicaid 8780803 NJ Other 9765851 CIGNA NJ Other 60037187 HORIZON NJ HEALTH NJ Other P3845837/2854869 OXFORD/UNITED HLTH.
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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KATHLEEN J JACKSON, RN-APN – NPI #1073619037Family

Contact Information

Specialty

Family

Adult Health

Nurse Practitioner

NPI Profile & details for KATHLEEN J JACKSON · (Female)

Reviews for KATHLEEN J JACKSON

KATHLEEN J JACKSON, RN-APN – NPI #1073619037
Family