Individual
MRS. CHELSEA NICOLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3922 W MARKET ST, GREENSBORO, NC 27407-1304
(336) 252-3993
(855) 308-2340
Mailing address
PO BOX 360, SYLVA, NC 28779-0360
(888) 339-6065
(828) 538-4441
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010583
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235622929
—
NC
01
—
19YAM
BCBS NC
NC
01
—
3164062
CIGNA
NC
01
—
LX493E-AC
DEVOTED HEALTH
NC
01
—
NN3436B
MEDICARE
NC
01
—
Q00928703
RAILROAD MEDICARE
NC
Enumeration date
06/07/2018
Last updated
02/11/2025
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