Lookup NPI Numbers from the NPI Registry
NPI Profile for DIANA L JACKSON in LEWISTON, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Acute Care |
363LA2100X | 50 | Nurse Practitioner | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner |
| NPI # | 1417498007 |
|
| Status | Active | |
| Credentials | AGACNP | |
| Entity | Individual | |
| Enumeration date | 03/15/2017 | |
| Last updated | 03/24/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DIANA L JACKSON
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DIANA L JACKSON, AGACNP