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Kimberly Dianne Billie Jackson, AGNP-C
Adult Health Nurse Practitioner in Sumter, South Carolina
NPI 1588293278

Kimberly Dianne Billie Jackson is an Adult Health Nurse Practitioner based in Sumter, SC and is specialized in Adult Health. Kimberly Dianne Billie Jackson practices in Sumter, SC and has the professional credentials of AGNP-C. The NPI Number for Kimberly Dianne Billie Jackson is 1588293278 and holds a License No. 23707 (South Carolina).

The current practice location address for Kimberly Dianne Billie Jackson is 940 Morningside Dr, Sumter, SC and can be reached out via phone at 914-359-7442 and via fax at 803-883-4087. You can also correspond with Kimberly Dianne Billie Jackson through the mailing address at PO BOX 141, SUMTER, SC - 29151-0141 (mailing address contact number: 914-359-7442).

Location: 940 Morningside Dr, Sumter, SC, 29151-0141
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588293278
Provider Name
Kimberly Dianne Billie Jackson
Credential
AGNP-C
Provider Entity Type
Individual
Gender
Female
Address
940 Morningside Dr, Sumter, SC, 29151-0141
Phone Number
914-359-7442
Fax Number
803-883-4087
Provider Enumeration Date
04/04/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AG01200075 01 AANP CERTIFICATION NUMBER
AG01200075 01 AMERICAN ASSOCIATION OF NURSE PRACTITIONERS CERTIFYING BOARD
institution
Provider Business Practice Location Address Details
Address
940 Morningside Dr
City
Sumter
State
South Carolina
Zip
29153-7724
Phone Number
914-359-7442
Fax Number
803-883-4087
person
Provider Business Mailing Address Details
Address
940 Morningside Dr
City
Sumter
State
South Carolina
Zip
29153-7724
Phone Number
914-359-7442
Fax Number
803-883-4087
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Community Health
Taxonomy
261QC1500X
License No.
APN.23707 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Laboratories
Classification
Clinical Medical Laboratory
Speciality
-
Taxonomy
291U00000X
License No.
APN.23707 (South Carolina)
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
23707 (South Carolina)
Definition
Definition to come...
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