Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KIMBERLY DIANNE BILLIE JACKSON, AGNP-C
Active Sole ProprietorKIMBERLY DIANNE BILLIE JACKSON, AGNP-C is a Community Health Center healthcare provider located in SUMTER, South Carolina. NPI 1588293278 is currently active in the NPPES registry. Verify at CMS.
Community Health Center · SUMTER, SC
Registration Details
- NPI Number
- 1588293278
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 4, 2020 (6.2168141249313 yrs)
- Last Updated
- Dec 27, 2021
- Licenses
-
23707 (SC)APN.23707 (SC)APN.23707 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
940 MORNINGSIDE DRSUMTER, SC, 291537724Browse SC providers · Browse ZIP 29153
- Phone
- 9143597442
- Fax
- 8038834087
- Primary Specialty
-
Community Health Center
261QC1500X
- Additional Specialty
- Community Health Center
- Additional Specialty
- Adult Health 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.