NPI age
3 years
Enumerated 2022-11-09
● Active
Type 1 · Individual
Kellontreia Laporche Jackson, A-GNP-C
Jackson is 1 of 5 nurse practitioner providers in Hawkinsville and 1 of 3206 in Georgia.
Primary specialty
Nurse Practitioner
Plus 5 subspecialties
Licensed in
GA, TX, IA, TN, CO, MI
6 states
Status
Active
No deactivations on record
Last NPPES update
2026-04-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 3206 active nurse practitioner providers in Georgia.
NPI age
3 years
↓ 5 yr below median (8 yr)
State licenses
6 states
Top 91% — 8% of peers are multi-state
Subspecialties
1
In the 30% of peers with subspecialties
NPI lifetime · 2022 → 2026
2022-11Enumerated in NPPES
2022
2026
Where they practice
Practice location
37 341 Byp
Hawkinsville, GA 310364839
Mailing address
4196 Highway 62 412 Ste A
Hardy, AR 725428002
Specialties
-
Nurse Practitioner Primary(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
-
Nurse PractitionerDefinition to come...
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.