MRS. KELLY ANN JACKSON AGNP
NPI 1174492185
Nurse Practitioner in Ewing, NJ

Q: What is Kelly Jackson's NPI number?

The NPI number for Kelly Jackson is 1174492185. It was assigned to this individual provider in the NPPES registry on October 30, 2025.

Q: What is Kelly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Jackson was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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 October 30, 2025

8 SCUDDER RD, EWING, NJ 08628(609) 586-6678 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mrs. Kelly Ann Jackson Agnp NPPES

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

MRS. KELLY ANN JACKSON AGNP (NPI 1174492185) is an individual nurse practitioner in Ewing, New Jersey, licensed in New Jersey (26NJ15451800) and active in the NPI registry since October 2025. She maintains a secondary practice location in Lawrenceville.

NPPES Registry Identity

NPI1174492185

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. KELLY ANN JACKSONCredential: AGNP

Location Address8 SCUDDER RDEwing, NJ 08628-2309

Mailing Address8 Scudder RdEwing, NJ 08628-2309

Phone(609) 586-6678

Sole ProprietorNo

Enumeration DateOctober 30, 2025

Last NPPES UpdateNovember 24, 2025

NPPES CertifiedNovember 24, 2025

✔ NPI 1174492185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NJ · 26NJ15451800

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

8 SCUDDER RD, Ewing, NJ 08628

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Secondary Practice Location 1

Location 14 Princess Rd Ste 206Lawrenceville, NJ 08648-2322 · Phone (609) 482-3701

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 Kelly Jackson's NPI number?

The NPI number for Kelly Jackson is 1174492185. It was assigned to this individual provider in the NPPES registry on October 30, 2025.

Where is Kelly Jackson located?

Kelly Jackson practices at 8 Scudder Rd, Ewing, NJ 08628. The listed phone number is (609) 586-6678.

What is Kelly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Kelly Jackson was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.