Individual
ANGELA VICTORIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
5201 CHARLOTTE PIKE, NASHVILLE, TN 37209-3320
(615) 222-1900
(615) 222-1917
Mailing address
700 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559
(907) 543-6000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0000008302
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3349491
—
TN
01
—
4301404
BCBST
TN
01
—
4321158
BLUE CROSS-BLUE SHIELD
TN
01
—
P01037353
RR MEDICARE
TN
Enumeration date
10/03/2006
Last updated
07/09/2020
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