Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kibibi A Jackson, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1831790526

Kibibi A Jackson, FNP-BC is a Nurse Practitioner in Riverdale, Georgia. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2020
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

483 Uppr Riverdale RD SW
Riverdale, GA 30274-2584
Phone: (770) 996-9400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN265070 (GA)
Family Medicine Physician Taxonomy 207Q00000X · Licence RN265070 (GA)

Record details

NPI number1831790526
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedNovember 8, 2020
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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