Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Kenneth James Jackson

Individual provider Family Nurse Practitioner · NPI 1700790060

Kenneth James Jackson is a Family Nurse Practitioner in Centerville, Ohio. Licensed in Ohio. Registered with an NPI since 2026.

Licensed in
OH
In the registry since
2026

Practice location Address checks out

7677 Yankee St Ste 140
Centerville, OH 45459-3475
Phone: (937) 293-3486
Fax: (937) 454-0077
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.0043539 (OH)

Record details

NPI number1700790060
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 1, 2026
Last updated in NPPESOctober 1, 2026
Certification dateOctober 1, 2026

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