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NPI Code Detail

MEDICARE: JOCELYN JACKSON ARNP

MEDICARE: JOCELYN JACKSON ARNP
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
1363LF0000XFamily Nurse PractitionerARNP9200079FL
2363LX0001XObstetrics & Gynecology Nurse PractitionerARNP9200079FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093176620
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYN JACKSON ARNP
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-343-6100
Fax Number : 239-343-9747
Provider Business Practice Location Address
First Line : 4761 S CLEVELAND AVE STE 4
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1375
Country : US
Telephone Number : 239-343-6100
Fax Number : 239-343-9747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2016
Last Update Date : 11/06/2025

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