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

Elizabeth Renee Jackson

Individual provider Medical Physician Assistant · NPI 1043033129

Elizabeth Renee Jackson is a Physician Assistant in Stillwater, Oklahoma. Qualified in 2024, 2 years ago. Practices with Stillwater Medical Center Authority, a 168-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024

Practice location Address checks out

1301 W 6th Ave
Stillwater, OK 74074-4375
Phone: (405) 533-1074
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1043033129
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 6, 2024
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026
Mailing address4622 N Rogers Dr, Stillwater, OK 74075-1654

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Stillwater Medical Center Authority — 168 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Stillwater