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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NAOMI JACKSON

Active Sole Proprietor

NAOMI JACKSON is a Community/Behavioral Health healthcare provider located in COTTAGE GROVE, Minnesota. NPI 1366229122 is currently active in the NPPES registry. Verify at CMS.

Community/Behavioral Health · COTTAGE GROVE, MN

Registration Details

NPI Number
1366229122
Provider Type
Individual
Gender
Female
NPI Issued
Sep 13, 2023 (2.7317599998979 yrs)
Last Updated
Sep 13, 2023
Licenses
1114922 (MN)
1112024 (MN)
1112024 (MN)
Sole Proprietor
Yes

Practice Information

Address
7691 62ND ST S
COTTAGE GROVE, MN, 550164676
Browse MN providers · Browse ZIP 55016
Phone
6514470398
Primary Specialty
Community/Behavioral Health
251S00000X
Additional Specialty
Community/Behavioral Health

Other Community/Behavioral Health Providers in COTTAGE GROVE, MN

Name Credential NPI
LIONEL NJITOR 1912682279
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.