Active NPI
Evelyn K. Jackson, MS, RN, FNP-C
- Family Nurse Practitioner
- Houston, TX
National Provider Identifier
1326197690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 249258
- Practice address
- 6565 Fannin St
STB 1160
Houston, TX 77030-2703 - Phone
- (713) 441-1366
- Fax
- (713) 441-7200
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 249258 | TX | Primary |
Addresses
Primary practice location
6565 Fannin St
STB 1160
Houston, TX 77030-2703
Mailing address
PO Box 1761
Pasadena, TX 77501-1761
Phone (281) 852-5319
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 249258 | Other | TX | RN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 249258 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326197690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1761",
"city": "PASADENA",
"state": "TX",
"postal_code": "775011761",
"telephone_number": "281-852-5319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6565 FANNIN ST",
"address_2": "STB 1160",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302703",
"telephone_number": "713-441-1366",
"fax_number": "713-441-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EVELYN",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "MS, RN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "249258",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "249258",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.