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

Kimberly Dianne Billie Jackson, AGNP-C

Individual provider Clinical Medical Laboratory · NPI 1588293278

Kimberly Dianne Billie Jackson, AGNP-C is a Clinical Medical Laboratory in Sumter, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.

Licensed in
SC
In the registry since
2020
Specialties on file
3

Practice location Address checks out

940 Morningside Dr
Sumter, SC 29153-7724
Phone: (914) 359-7442
Fax: (803) 883-4087
Show map & directions

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

Specialties & licences

Community Health Clinic/Center (primary) Taxonomy 261QC1500X · Licence APN.23707 (SC)
Clinical Medical Laboratory Taxonomy 291U00000X · Licence 23707 (SC)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence APN.23707 (SC)

Record details

NPI number1588293278
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorYes
NPI enumeratedApril 4, 2020
Last updated in NPPESDecember 27, 2021
Certification dateDecember 27, 2021

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