IndividualActive
Kierney Jackson, PA
NPI 1003057621 · Physician Assistant · Gainesville, GA
Provider details
- NPI number
- 1003057621
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- 1397 (SC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
200 S Enota Dr Ne Ste 360
Gainesville, GA 30501-3466
Phone: (770) 219-4000
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 742616
Atlanta, GA 30374-2616
Additional practice locations (1)
- 1350 S Kings DrCharlotte, NC 28207-2134Phone: (704) 446-1255Fax: (704) 446-1276
Registry dates
- Enumerated
- 2009-03-11
- Last updated
- 2025-09-25
- Certified
- 2025-09-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.