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Contact Information

TIFFANY JACKSON, FNP-C
529 LAKE STREET
SUITE B
HAZLEHURST, MS39083
 Phone: 601-623-9245
 Fax: 601-623-9246
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for TIFFANY JACKSON · (Female)

NPI # 1124410022
Status Active
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 03/02/2015
Last updated 04/19/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MS License # F0115051
  • MS Medicaid 07833786
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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