MEDICARE: MRS. YALONDA NACHOLE JACKSON MSN,ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9258698	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255747796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YALONDA NACHOLE JACKSON MSN,ARNP

Provider Business Mailing Address
First Line	:	2623 S SEACREST BLVD STE 114
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7531
Country	:	US
Telephone Number	:	561-955-4600
Fax Number	:	833-625-1606

Provider Business Practice Location Address
First Line	:	2623 S SEACREST BLVD STE 114
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7531
Country	:	US
Telephone Number	:	561-955-4600
Fax Number	:	833-625-1606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2014
Last Update Date	:	05/27/2026

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