IndividualActive
Amanda Jackson
NPI 1295581486 · Psychiatric/Mental Health Nurse Practitioner · Southaven, MS
Provider details
- NPI number
- 1295581486
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 906654 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
919 Ferncliff Cv Ste 1
Southaven, MS 38671-2402
Phone: (662) 205-5045
Fax: (844) 444-1263
Approximate (ZIP-level) locationGet directions
Mailing address
919 Ferncliff Cv Ste 1
Southaven, MS 38671-2402
Registry dates
- Enumerated
- 2024-04-29
- Last updated
- 2026-01-12
- Certified
- 2026-01-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.