Individual
KIMBERLY DIANNE BILLIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
940 MORNINGSIDE DR, SUMTER, SC 29153-7724
(914) 359-7442
(803) 883-4087
Mailing address
PO BOX 141, SUMTER, SC 29151-0141
(914) 359-7442
(803) 883-4087
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
APN.23707
SC
291U00000X
Clinical Medical Laboratory
23707
SC
363LA2200X
Adult Health Nurse Practitioner
APN.23707
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AG01200075
AANP CERTIFICATION NUMBER
—
Enumeration date
04/04/2020
Last updated
12/27/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us