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

Tiffany Jackson

Individual provider Registered Nurse · NPI 1124762794

Tiffany Jackson is a Nurse Practitioner in Southaven, Mississippi. Qualified in 2024, 2 years ago. Practices with My Mobile MD Psychiatric Services LLC, a 17-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
2
Licensed in
MS
In the registry since
2022
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Practice location Address checks out

5875 Landau Dr
Southaven, MS 38671-8946
Phone: (870) 821-1234
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 917293 (MS)

Record details

NPI number1124762794
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 20, 2022
Last updated in NPPESApril 20, 2022
Certification dateApril 20, 2022
Mailing address5875 Landau Dr, Southaven, MS 38671-8946

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice My Mobile Md Psychiatric Services Llc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Southaven