IndividualActive
Amanda Jackson, CPNP
NPI 1205460045 · Pediatric Nurse Practitioner · Nixa, MO
Provider details
- NPI number
- 1205460045
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP
- Sex
- Female
- Sole proprietor
- No
- License
- 2011022742 (MO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Practice location
940 W Mount Vernon St Ste 220
Nixa, MO 65714-9613
Phone: (417) 724-5437
Approximate (ZIP-level) locationGet directions
Mailing address
940 W Mount Vernon St Ste 220
Nixa, MO 65714-9613
Registry dates
- Enumerated
- 2020-03-02
- Last updated
- 2020-03-11
- Certified
- 2020-03-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.