KELLIE SUZANNE JACKSON RN
NPI 1043995517
Registered Nurse in Mount Airy, NC

Q: What is Kellie Jackson's NPI number?

The NPI number for Kellie Jackson is 1043995517. It was assigned to this individual provider in the NPPES registry on June 21, 2023. The provider is also known as Kellie Jackson Easter.

Q: What is Kellie Jackson's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Jackson was last updated on June 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 June 21, 2023

414 W LEBANON ST, MOUNT AIRY, NC 27030(336) 789-9492(336) 789-9587 Get Directions Write a Review

NPPES record last updated: June 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kellie Suzanne Jackson Rn NPPES

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

KELLIE SUZANNE JACKSON RN (NPI 1043995517) is an individual registered nurse in Mount Airy, North Carolina, licensed in North Carolina (172497) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1043995517

Entity TypeIndividualFemale

Primary Taxonomy163W00000X

Provider Legal NameKELLIE SUZANNE JACKSONCredential: RN

Location Address414 W LEBANON STMount Airy, NC 27030-2954

Mailing Address414 W Lebanon StMount Airy, NC 27030-2954 · (336) 789-9492 · Fax (336) 789-9587

Phone(336) 789-9492

Fax(336) 789-9587

Sole ProprietorYes

Enumeration DateJune 21, 2023

NPPES CertifiedJune 21, 2023

✔ NPI 1043995517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers

Taxonomy Code163W00000X

License✔ Licensed in NC · 172497

Definition

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

414 W LEBANON ST, Mount Airy, NC 27030

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Other Names 1

Former Name (1)Kellie Jackson Easter

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.

JULIE BRANDENBURG MCDOWELL PA

Physician Assistant