- Practice location
- 1791 Alum Creek Dr Ste 100, Columbus, OH 43207
- Phone
- 614-526-5420
- Fax
- 614-645-5517
- Last updated
- August 6, 2019
Dominique Terence Jackson is a Nurse Practitioner, Family based in Columbus, OH. Dominique Terence Jackson practices in Columbus, OH and has the professional credentials of NURSE PRACTITIONER. The NPI Number for Dominique Terence Jackson is 1174081822 and holds a License No. APRN.CNP.024669 (OH). The current practice location address for Dominique Terence Jackson is 1791 Alum Creek Dr Ste 100, Columbus, OH 43207 and can be reached out via phone at 614-526-5420 and via fax at 614-645-5517.
Provider Profile Details
- NPI Number
- 1174081822
- Provider Name
- Dominique Terence Jackson
- Credential
- NURSE PRACTITIONER
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1791 Alum Creek Dr Ste 100, Columbus, OH 43207
- Phone Number
- 614-526-5420
- Fax Number
- 614-645-5517
- Primary Taxonomy
- Nurse Practitioner, Family · 363LF0000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 12, 2019
- Last Update Date
- August 6, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1791 Alum Creek Dr Ste 100
Columbus, OH 43207 - City
- Columbus
- State
- Ohio
- Zip
- 43207
- Phone Number
- 614-526-5420
- Fax Number
- 614-645-5517
Provider Business Mailing Address Details
- Address
- 2780 Airport Dr Ste 100
Columbus, OH 43219-2289 - City
- Columbus
- State
- OH
- Zip
- 43219-2289
- Phone Number
- 614-859-1906
- Fax Number
- 614-645-5517
License Information
- License Number (1)
- APRN.CNP.024669
- License State (1)
- OH
- Taxonomy (1)
- Nurse Practitioner, Family · 363LF0000X · Primary
- Taxonomy (2)
- Student in an Organized Health Care Education/Training Program · 390200000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nurse Practitioner, Family providers near Columbus, OH
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Frequently Asked Questions
What is the NPI number of Dominique T Jackson, NURSE PRACTITIONER?
The NPI number of Dominique T Jackson, NURSE PRACTITIONER is 1174081822. It was assigned on March 12, 2019 and is currently active in the NPPES registry.
What is the specialty of Dominique T Jackson, NURSE PRACTITIONER?
Dominique T Jackson, NURSE PRACTITIONER is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X), licensed in OH under license number APRN.CNP.024669.
Where does Dominique T Jackson, NURSE PRACTITIONER practice?
The practice location is 1791 Alum Creek Dr Ste 100, Columbus, OH 43207. The office can be reached at 614-526-5420 (phone) or 614-645-5517 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1174081822 directly on the NPPES registry website.