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Individual

FREDERICKA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4141 N 156TH ST STE 202, OMAHA, NE 68116-1427
(402) 242-5078
(402) 508-8771
Mailing address
4141 N 156TH ST STE 202, OMAHA, NE 68116-1427
(402) 242-5078
(402) 508-8771

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
112991
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
112991
NE

Other

Enumeration date
10/08/2019
Last updated
03/23/2026
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