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

Beverly Joanne Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1023956224

Beverly Joanne Jackson is a Student in an Organized Health Care Education/Training Program in Idaho Falls, Idaho. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone: (208) 529-6111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1023956224
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 23, 2026
Last updated in NPPESMarch 23, 2026
Certification dateMarch 22, 2026
Mailing address3100 Channing Way, Idaho Falls, ID 83404-7533

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