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General NPI Number Information
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NPI Number | 1497953152
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Entity Type | Individual
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Provider Name | FELICIA ATHENS JACKSON PH.D., MCJ, RN
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Gender | Female
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Dates
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Enumeration Date | 07/04/2007
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 4634 BELFAST DR
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City | COLUMBUS
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State | OH
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Zip | 43227-2527
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Country | US
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Telephone | 614-861-0983
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Fax | 614-860-0487
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Provider Business Mailing Address
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Address Line | 4634 BELFAST DR
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City | COLUMBUS
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State | OH
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Zip | 43227-2527
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Country | US
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Telephone | 614-861-0983
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Fax | 614-860-0487
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN26987
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN269287
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | RN269287
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN269287
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN269287
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN269287
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License Number State | OH
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