Individual
KIBIBI A JACKSON
Active
Individual
KIBIBI A JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN265070
GA
207Q00000X
Family Medicine Physician
RN265070
GA
363LF0000X
Family Nurse Practitioner
Primary
RN265070
GA
Other
Enumeration date
11/08/2020
Last updated
02/18/2026
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