Individual
KAILI ANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
2546 BALLTOWN RD STE 200, NISKAYUNA, NY 12309-1079
(518) 374-1444
(518) 374-0491
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F312706-01
NY
Other
Enumeration date
02/18/2026
Last updated
03/03/2026
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