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NPI Code Detail

MEDICARE: MS. APRIL ANTIONETTE JACKSON APRN

MEDICARE: MS. APRIL ANTIONETTE JACKSON APRN
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
1163W00000XRegistered Nurse160802TN
2363LF0000XFamily Nurse Practitioner25541TN
3363LF0000XFamily Nurse Practitioner1072252TX

General Provider Information

NPI Number : 1144519612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. APRIL ANTIONETTE JACKSON APRN
Provider Business Mailing Address
First Line : 716 N HIGHWAY 67 STE 2
Second Line :
City : CEDAR HILL
State : TX
Zip : 75104-2117
Country : US
Telephone Number : 972-291-9165
Fax Number : 469-575-9975
Provider Business Practice Location Address
First Line : 716 N HIGHWAY 67 STE 2
Second Line :
City : CEDAR HILL
State : TX
Zip : 75104-2117
Country : US
Telephone Number : 972-291-9165
Fax Number : 469-575-9975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2011
Last Update Date : 07/15/2024

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