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

Kellie Suzanne Jackson, RN

Individual provider Registered Nurse · NPI 1043995517

Kellie Suzanne Jackson, RN is a Registered Nurse in Mount Airy, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2023
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

See every abbreviation used in this directory →

Practice location Address checks out

414 W Lebanon St
Mount Airy, NC 27030-2954
Phone: (336) 789-9492
Fax: (336) 789-9587
Show map & directions

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

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 172497 (NC)

Record details

NPI number1043995517
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedJune 21, 2023
Last updated in NPPESJune 21, 2023
Certification dateJune 21, 2023
Mailing address414 W Lebanon St, Mount Airy, NC 27030-2954

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