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Individual
MRS. MELISSA MORGAN JACKSON
Active
Individual
MRS. MELISSA MORGAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4005723
KY
363L00000X
Nurse Practitioner
Primary
4005723
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100911000
—
KY
Enumeration date
06/28/2023
Last updated
09/28/2026
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