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NPI Code Detail

MEDICARE: DR. REBECCA RAIN JACKSON DO

MEDICARE: DR. REBECCA RAIN JACKSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician47225CO
2207QG0300XGeriatric Medicine (Family Medicine) Physician47225CO

General Provider Information

NPI Number : 1568621613
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA RAIN JACKSON DO
Provider Business Mailing Address
First Line : 2118 ESSEX CT
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1615
Country : US
Telephone Number : 970-646-8396
Fax Number :
Provider Business Practice Location Address
First Line : 2021 BATTLECREEK DR UNIT A
Second Line :
City : FORT COLLINS
State : CO
Zip : 80528-5120
Country : US
Telephone Number : 970-568-5810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2008
Last Update Date : 06/04/2025

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