MEDICARE: COURTNEY CARSON JACKSON

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
1	363A00000X	Physician Assistant	PA9116193	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1902521354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY CARSON JACKSON

Provider Business Mailing Address
First Line	:	2529 CEDAR TRACE DR E
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-9351
Country	:	US
Telephone Number	:	904-514-5750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1633 RACE TRACK RD STE 101
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32259-3237
Country	:	US
Telephone Number	:	904-230-6988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2022
Last Update Date	:	10/07/2022

Similar Medicare Providers

1992178719 — SONILA MUSTA-KINA PA-C
Practice Location Address:

1633 RACE TRACK RD STE 101
JACKSONVILLE, FL
32259-3237

Practice Phone: 904-230-6988
Practice Fax:

1841599438 — DR. CHARMAINE A AGUIRRE MD
Practice Location Address:

1351 13TH AVE S STE 110
JACKSONVILLE BEACH, FL
32250-3237

Practice Phone: 904-249-9995
Practice Fax:

1013301696 — ANTHONY L CAPASSO MD PRIMARY CARE
Practice Location Address:

1351 13TH AVE S STE 110
JACKSONVILLE BEACH, FL
32250-3237

Practice Phone: 904-249-9995
Practice Fax: 904-249-9449

1245614114 — SHANNON JANE O'BRIEN F.N.P.
Practice Location Address:

1315 13TH AVENUE S SUITE 110
JACKSONVILLE BEACH, FL
32250-3237

Practice Phone: 904-249-9995
Practice Fax: 904-249-9449

1417309832 — BEACHES BEHAVIORAL MEDICINE
Practice Location Address:

1351 13TH AVE S STE 120
JACKSONVILLE BEACH, FL
32250-3237

Practice Phone: 904-280-6701
Practice Fax: 904-280-6702

1003483850 — GLYNNIS MARIE WINFREE APRN
Practice Location Address:

1351 13TH AVE S STE 120
JACKSONVILLE BEACH, FL
32250-3237

Practice Phone: 904-223-3321
Practice Fax: 904-223-2169

Directions to “ COURTNEY CARSON JACKSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.