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

Kim B Jackson

Individual provider Massage Therapist · NPI 1003415464

Kim B Jackson is a Massage Therapist in Glen Cove, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2020
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Practice location Address checks out

29 Glen Cove Ave Ste 212
Glen Cove, NY 11542-2831
Phone: (516) 384-7670
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 028858 (NY)

Record details

NPI number1003415464
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 18, 2020
Last updated in NPPESOctober 18, 2020
Certification dateOctober 18, 2020

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