Individual
KRISTA L. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
313 WEST ST, PAINTSVILLE, KY 41240-1054
(606) 788-6415
(606) 372-6001
Mailing address
313 WEST ST, PAINTSVILLE, KY 41240-1054
(606) 788-6415
(606) 372-6001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 586
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520426
BCBS
KY
05
—
95003141
—
KY
01
—
P00290504
RAILROAD
—
Enumeration date
01/11/2006
Last updated
08/06/2026
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