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

SHELBY L JACKSON, CHW

Active Sole Proprietor

SHELBY L JACKSON, CHW is a Community Health Worker healthcare provider located in GALLUP, New Mexico. NPI 1508652678 is currently active in the NPPES registry. Verify at CMS.

Community Health Worker · GALLUP, NM

Registration Details

NPI Number
1508652678
Provider Type
Individual
Gender
Female
NPI Issued
Apr 16, 2025 (1.2949771662928 yrs)
Last Updated
May 29, 2025
Licenses
0018-2025 (NM)
S1-1776 (NM)
Sole Proprietor
Yes

Practice Information

Address
2111 COLLEGE DR
GALLUP, NM, 873015600
Browse NM providers · Browse ZIP 87301
Phone
5053975172
Fax
5053975172
Primary Specialty
Community Health Worker
172V00000X
Additional Specialty
Community Health Worker

Other Community Health Worker Providers in GALLUP, NM

Name Credential NPI
BRIAN PIERCE 1407120744
MS. JAYLYN DENISE RANDLES CPSW, CHW 1962269118
MR. SCOTT DANIEL BURGNER 1952152514
MRS. KERRILYN THOMAS 1891520375
KRISTEN JOY PIKAART CHW 1164230090
JERRY JAMES ORR CCSS 1598564544
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.