Andrea Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

309107 Issued in AZ

Practice address

4990 E Mediterranean Dr Ste a
Sierra Vista, AZ 85635-2495

Phone

(520) 439-5186

NPI assigned

Dec 8, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carnett Clinic LLCGroup PAC ID 5890732655, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carnett Clinic, LLC

  • Adult Medicine Physician
  • Sierra Vista, AZ
  • NPI 1790961167
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• RCHP-Sierra Vista Inc

  • Rural Health Clinic/Center
  • Sonoita, AZ
  • NPI 1013160290

  Hospital

  Care Compare affiliation
• RCHP-Sierra Vista Inc

  • General Acute Care Hospital
  • Sierra Vista, AZ
  • NPI 1194766543
  Care Compare affiliation
• RCHP-Sierra Vista Inc

  • Rural Health Clinic/Center
  • Tombstone, AZ
  • NPI 1508010471

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1043173958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3494 HERBA DE MARIA",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856509588",
            "telephone_number": "417-389-9987",
            "fax_number": "417-389-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 E MEDITERRANEAN DR STE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352495",
            "telephone_number": "520-439-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDREA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "309107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intercept Speech and Language, LLC
• Nusrum Iqbal, MD
• Renee Ann Irlmeier
• Tahera Islam, RD
• Justin Israelsen, DMD
• Janell Ann Jackson, R.N.
• Joan Lynne Jackson, OTR/L
• Marissa Jackson
• Paul Charles Jackson, PTA
• Dawn Marie Jacobson, RN

• Family Nurse Practitioner in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.