Julia Anne Jackson, APRN

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

205727 Issued in OK

Practice address

1422 E 71St St Ste B
Tulsa, OK 74136-5060

Phone

(918) 710-0422

Fax

(918) 949-6681

NPI assigned

Oct 11, 2022

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1083339022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 E 71ST ST STE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365060",
            "telephone_number": "918-710-0422",
            "fax_number": "918-949-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 E 71ST ST STE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365060",
            "telephone_number": "918-710-0422",
            "fax_number": "918-949-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JULIA",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OK",
            "license": "205727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN- CNS",
            "identifier": "205727",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "goodsamaritanhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1422 E 71st St Ste B",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741365060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jarrett Jackson
• Jeannine Jackson, COTA/L
• Jennifer Jackson, M.S.
• Joanna Lee Jackson, LPC-CANDIDATE
• Joseph Aaron-Hollister Jackson
• Kaci Lynn Jackson, ARNP
• Kailyn Jackson
• Karis Lavon Jackson Sr.
• Katie Elizabeth Jackson, MD
• Katina Jackson, APRN

• Clinical Nurse Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinical Nurse Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.