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DR. KIMBERLEY EVELYN JACKSON D.O.
NPI 1154586832
General Practice in Pueblo, CO

Active since July 22, 2008
902 LAKEVIEW AVE, PUEBLO, CO 81004(719) 557-5855(719) 557-4690 Get Directions Write a Review

NPPES record last updated: September 16, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kimberley Evelyn Jackson D.o. NPPES

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

DR. KIMBERLEY EVELYN JACKSON D.O. (NPI 1154586832) is an individual general practice provider in Pueblo, Colorado, licensed in Pennsylvania (OS014960) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1154586832
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameDR. KIMBERLEY EVELYN JACKSONCredential: D.O.
Location Address902 LAKEVIEW AVEPueblo, CO 81004-3597
Mailing Address902 Lakeview AvePueblo, CO 81004-3597 · (719) 557-5855 · Fax (719) 557-4690
Phone(719) 557-5855
Fax(719) 557-4690
Sole ProprietorNo
Enumeration DateJuly 22, 2008
Last NPPES UpdateSeptember 16, 2011
✔ NPI 1154586832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in PA · OS014960
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
902 LAKEVIEW AVE, Pueblo, CO 81004
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Other Identifiers 2

OtherOS014960PA · Pennsylvania Osteopathic Medical Board
Other50533CO · Colorado License

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.

DR. CAMILA TERESA ROBLES DO
Family Medicine
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872
MARK DAVIS PA-C
Physician Assistant
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
MADISON BASSETT
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
REBECKA ANN REATHERFORD AGACNP-BC
Nurse Practitioner (Acute Care)
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
LUCINEI GERALDO STADNIK MD
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872
DR. LISA HAMILTON MD
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872
TIFFANY ANNE GARCIA FNP
Nurse Practitioner (Family)
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5855
DR. SUHAILA OBAIDALLA MD
Student in an Organized Health Care Education/Training Program
902 LAKEVIEW AVE
PUEBLO, CO 81004
Pueblo County (719) 557-5872

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberley Jackson's NPI number?

The NPI number for Kimberley Jackson is 1154586832. It was assigned to this individual provider in the NPPES registry on July 22, 2008.

Where is Kimberley Jackson located?

Kimberley Jackson practices at 902 Lakeview Ave, Pueblo, CO 81004. The listed phone number is (719) 557-5855.

What is Kimberley Jackson's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Kimberley Jackson was last updated on September 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.