Dominique Jackson, PMHNP - Nurse Practitioner in Bronx, NY

Dominique Jackson, PMHNP is a Nurse Practitioner - Psychiatric/mental Health based in Bronx, New York. Dominique Jackson is licensed to practice in New York (license number 406069) and her current practice location is 2244 Bronx Park E Apt 2d, Bronx, New York. She can be reached at her office (for appointments etc.) via phone at (407) 924-3771.

NPI number for Dominique Jackson is 1811696560 and her current mailing address is 2244 Bronx Park E Apt 2d, Bronx, New York. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1811696560.

Contact Information

Dominique Jackson, PMHNP
2244 Bronx Park E Apt 2d,
Bronx, NY 10467-7516
(407) 924-3771
Not Available

Map and Direction




Provider's Profile

Full NameDominique Jackson
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location2244 Bronx Park E Apt 2d, Bronx, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1811696560
  • Provider Enumeration Date: 03/01/2023
  • Last Update Date: 07/08/2024

Medical Identifiers

Medical identifiers for Dominique Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811696560NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 767792 (New York)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 406069 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominique Jackson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dominique Jackson, PMHNP
2244 Bronx Park E Apt 2d,
Bronx, NY 10467-7516

Ph: (407) 924-3771
Dominique Jackson, PMHNP
2244 Bronx Park E Apt 2d,
Bronx, NY 10467-7516

Ph: (407) 924-3771

Reviews and Comments


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