Provider Demographics
NPI:1609262898
Name:JACKSON, CHRISTINA PARKER (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:PARKER
Last Name:JACKSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 HIGHWAY 41A STE 108
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-8221
Mailing Address - Country:US
Mailing Address - Phone:615-746-6091
Mailing Address - Fax:615-746-6095
Practice Address - Street 1:6312 HIGHWAY 41A STE 108
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-8221
Practice Address - Country:US
Practice Address - Phone:615-746-6091
Practice Address - Fax:615-746-6095
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174854163W00000X
TN19867363LF0000X
AL3-000028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse