Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Angel Jackson

Individual provider Registered Nurse · NPI 1407560402

Angel Jackson is a Registered Nurse in Charleston, West Virginia. Licensed in West Virginia. Registered with an NPI since 2023.

Licensed in
WV
In the registry since
2023
Specialties on file
2

Practice location Address checks out

400 S Ruffner Rd Ste 11
Charleston, WV 25314-1542
Phone: (304) 720-9595
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 123472 (WV)
Registered Nurse Taxonomy 163W00000X · Licence 91990 (WV)

Record details

NPI number1407560402
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 13, 2023
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026

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