MRS. KIMBERLY ANN JACKSON ARNP
NPI 1023135126
Nurse Practitioner - Women's Health in Providence, KY

Q: What is Kimberly Jackson's NPI number?

The NPI number for Kimberly Jackson is 1023135126. It was assigned to this individual provider in the NPPES registry on March 23, 2007.

Q: What is Kimberly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Jackson was last updated on March 2, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 23, 2007

215 E MAIN ST, PROVIDENCE, KY 42450(270) 667-7017(270) 667-9065 Get Directions Write a Review

NPPES record last updated: March 2, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 2, 2018, Jan 15, 2016 (2 updates tracked since 2016).

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About Mrs. Kimberly Ann Jackson Arnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KIMBERLY ANN JACKSON ARNP (NPI 1023135126) is an individual women's health provider in Providence, Kentucky, licensed in Kentucky (1086349) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1023135126

Entity TypeIndividualFemale

Primary Taxonomy363LW0102X

Provider Legal NameMRS. KIMBERLY ANN JACKSONCredential: ARNP

Location Address215 E MAIN STProvidence, KY 42450-1261

Mailing AddressPo Box 37Providence, KY 42450-0037 · (270) 667-7017 · Fax (270) 667-9065

Phone(270) 667-7017

Fax(270) 667-9065

Sole ProprietorNo

Enumeration DateMarch 23, 2007

Last NPPES UpdateMarch 2, 20182 updates tracked since enumeration

✔ NPI 1023135126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LW0102X

License✔ Licensed in KY · 1086349

215 E MAIN ST, Providence, KY 42450

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Other Identifiers 2

OtherK185610KY · Medicare - Rhca

Medicaid7100128660KY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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