# MELINDA LOUISE JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1225673445
- **Gender:** F
- **Credential:** CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 1-117801 | AL | — |
| 363LN0000X | Neonatal Nurse Practitioner | 1-117801 | AL | Yes |
| 363LN0005X | Critical Care Neonatal Nurse Practitioner | 1-117801 | AL | — |

## Other

- **Enumeration date:** 11/12/2019
- **Last updated:** 01/19/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NA | NA | — |