Breanna J Jackson, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

209033792 Issued in IL

Practice address

313 N 26TH St
Mattoon, IL 61938-2556

Phone

(217) 480-5829

NPI assigned

Apr 8, 2026

Last updated

Apr 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1144162090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 CHAMPAIGN AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619382548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 N 26TH ST",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619382556",
            "telephone_number": "217-480-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BREANNA",
        "middle_name": "J",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209033792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Order of Odd Fellows (Odd Fellow Rebekah Home)
• Independent Order of Odd Fellows (Odd Fellow Rebekah Home)
• Roza Ioffe, M.D.
• Randy R Isaacs, MD
• Shemariah Laish Israel, MD
• Cheyenne Jackson, BS
• Sierra Laine Jackson
• Gary Jacobs
• Kelsey S. Jacobson, B.A.
• Kuppuswamy Jagarlamudi, M.D.

• Women's Health Nurse Practitioner in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Women's Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.