KATHLEEN J. JACKSON RN-APN NPI 1073619037

NPI Information

NPI: 1073619037
Provider Name: KATHLEEN J. JACKSON, RN-APN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
602 W CUTHBERT BLVD UNIT 26
HADDON TOWNSHIP, NJ
ZIP 08108
Phone: (856) 946-5180
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Kathleen J. Jackson, RN-APN is a family nurse practitioner in Haddon Township, NJ with 13 years of experience. Kathleen J. Jackson, RN-APN NPI is 1073619037. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

602 W CUTHBERT BLVD UNIT 26
HADDON TOWNSHIP, NJ
ZIP 08108-642
Phone: (856) 946-5180
Fax: (856) 946-5181

The NPI 1073619037 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 5/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		TP001754C	PENNSYLVANIA	No
2	363LA2200X	Nurse Practitioner	Adult Health	26NN06425500	NEW JERSEY	No
3	363LF0000X	Nurse Practitioner	Family	26NN06425500	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8780803	MEDICAID	NEW JERSEY
2	P3845837/2854869	OTHER	NEW JERSEY	OXFORD/UNITED HLTH.
3	9765851	OTHER	NEW JERSEY	CIGNA
4	60037187	OTHER	NEW JERSEY	HORIZON NJ HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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