Provider Demographics
NPI:1740836485
Name:JACKSON, BRITTANY LEIGH (FNP-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEIGH
Last Name:JACKSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:LEIGH
Other - Last Name:SPENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:108 PANTEGO PL
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-8216
Mailing Address - Country:US
Mailing Address - Phone:919-273-5133
Mailing Address - Fax:
Practice Address - Street 1:325 NC-55 WEST
Practice Address - Street 2:
Practice Address - City:MT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365
Practice Address - Country:US
Practice Address - Phone:919-658-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF06190592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily