NPI 1205763893

Virgil Jackson

Practitioner Foster Care Agency Elkhorn, NE

Practice location

Address: 2507 N 187th Ave, Elkhorn, NE 68022-4539
Phone: (918) 304-9225
Mailing address: 4805 N 72nd St, Omaha, NE 68134-2304

Registered specialties

Foster Care Agency Primary

Agencies Taxonomy 253J00000X

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Registry record

NPI: 1205763893
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 May 2026
Record last updated: 6 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.