Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ellanikole Jackson, DNP

Individual provider Family Nurse Practitioner · NPI 1932676194

Dr. Ellanikole Jackson, DNP is a Nurse Practitioner in Counce, Tennessee. Qualified in 2018, 8 years ago. Practices with Family Clinic at the Lake PLLC, a 3-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
8
Licensed in
TN
In the registry since
2018
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

11268 Highway 57
Counce, TN 38326-3802
Phone: (731) 438-3456
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 24869 (TN)

Record details

NPI number1932676194
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP
Sole proprietorNo
NPI enumeratedOctober 25, 2018
Last updated in NPPESJuly 24, 2024
Certification dateJuly 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Family Clinic At The Lake Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Counce