Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA JACKSON, CPNP
ActiveAMANDA JACKSON, CPNP is a Pediatric Nurse Practitioner healthcare provider located in NIXA, Missouri. NPI 1205460045 is currently active in the NPPES registry. Verify at CMS.
Pediatric Nurse Practitioner · NIXA, MO
Registration Details
- NPI Number
- 1205460045
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 2, 2020 (6.4664874391092 yrs)
- Last Updated
- Mar 11, 2020
- Licenses
-
2011022742 (MO)2020008008 (MO)
Practice Information
- Address
-
940 W MOUNT VERNON ST STE 220NIXA, MO, 657149613Browse MO providers · Browse ZIP 65714
- Phone
- 4177245437
- Primary Specialty
-
Pediatric Nurse Practitioner
363LP0200X
- Additional Specialty
- Pediatric Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.