Jennifer Beth Jackson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

617961 Issued in TX

Practice address

318 N 23Rd St
Beaumont, TX 77707

Phone

(409) 210-5080

Fax

(409) 242-2123

NPI assigned

Feb 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1639357692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N 23RD ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77707",
            "telephone_number": "409-210-5080",
            "fax_number": "409-242-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N 23RD ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77707",
            "telephone_number": "409-210-5080",
            "fax_number": "409-242-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "617961",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "617961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J & C Orthotics and Prosthetics
• J a M Daycare Health and Services LLC
• J.C.V.K. Inc.
• Jackson T. Achilles, MD PA
• Christine S Jackson, NP-C
• Kristina Gayle Jackson, C.R.N.A.
• Sharon K. Jackson, O.T.R.
• Marcusella Stevenson Jagneaux, D.C.
• Nicole Yvette Jaikaran, M.D.
• Pragya Jain, MD

• Family Nurse Practitioner in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.