MS. KIMBERLY A JACKSON PMHNP, FNP
NPI 1083923353
Nurse Practitioner - Psychiatric/Mental Health in Brooklyn, NY
Active since October 04, 2010
About Ms. Kimberly A Jackson Pmhnp, Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. KIMBERLY A JACKSON PMHNP, FNP (NPI 1083923353) is an individual psychiatric/mental health provider in Brooklyn, New York, licensed in New York (403954) and active in the NPI registry since October 2010.
NPPES Registry Identity
NPI1083923353
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMS. KIMBERLY A JACKSONCredential: PMHNP, FNP
Location Address266 BROADWAY STE 401Brooklyn, NY 11211-6306
Mailing Address266 Broadway Ste 401Brooklyn, NY 11211-6306 · (347) 696-1375 · Fax (914) 222-8973
Phone(347) 696-1375
Fax(914) 222-8973
Sole ProprietorYes
Enumeration DateOctober 4, 2010
Last NPPES UpdateJanuary 29, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 29, 2026
✔ NPI 1083923353 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in NY · 403954✔ Licensed in CT · 12.007638
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 336506 (NY)
266 BROADWAY STE 401, Brooklyn, NY 11211
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Clinic/Center (Medical Specialty)
266 BROADWAY STE 401
BROOKLYN, NY 11211
BROOKLYN, NY 11211
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083923353, enumerated as an "individual" on October 04, 2010.
The provider is located at 266 BROADWAY STE 401 BROOKLYN, NY 11211 and the phone number is (347) 696-1375.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
