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NPI Code Detail

MEDICARE: MELINDA ANN JACKSON FNP-C

MEDICARE: MELINDA ANN JACKSON FNP-C
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
1363LF0000XFamily Nurse PractitionerSP012232PA

General Provider Information

NPI Number : 1528315983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA ANN JACKSON FNP-C
Provider Business Mailing Address
First Line : 161 PENN CREST DR
Second Line :
City : WHITE OAK
State : PA
Zip : 15131-2746
Country : US
Telephone Number : 412-853-5015
Fax Number :
Provider Business Practice Location Address
First Line : 9201 E MOUNTAIN VIEW RD STE 200
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-5172
Country : US
Telephone Number : 877-561-7335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2012
Last Update Date : 10/02/2024

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Directions to “ MELINDA ANN JACKSON FNP-C” Practice Location

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