IndividualActive
Kimberly Jackson
NPI 1407796774 · Nurse Practitioner · Millbrook, AL
Provider details
- NPI number
- 1407796774
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 1-170200 (AL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
222 Fairway Dr
Millbrook, AL 36054-1846
Phone: (334) 322-4886
Approximate (ZIP-level) locationGet directions
Mailing address
222 Fairway Dr
Millbrook, AL 36054-1846
Registry dates
- Enumerated
- 2026-03-30
- Last updated
- 2026-03-30
- Certified
- 2026-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.