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Contact Information

KIMBERLY JACKSON FNP LLC
31 WEBER HILL RD
MAHOPAC, NY10541-1829
 Phone: 914-260-8087
 Fax: 845-767-5088
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KIMBERLY JACKSON FNP LLC

NPI # 1811350770
LBN Legal business name KIMBERLY JACKSON FNP LLC
Authorized official KIMBERLY JACKSON - (OWNER/PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/29/2016
Last updated 03/30/2016 - About 10 years ago
Identifiers
NY License # 336506
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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