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

Ethan Jared Jackson

Individual provider Certified Registered Nurse Anesthetist · NPI 1376348185

Ethan Jared Jackson is a Certified Registered Nurse Anesthetist (CRNA) in Plymouth, Minnesota. Qualified in 2025, 1 year ago. Practices with Metropolitan Anesthesia Network LLP, a 519-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
1
Licensed in
MN
In the registry since
2025
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

14700 28th Ave N Ste 20
Plymouth, MN 55447-4876
Phone: (763) 559-3779
Fax: (763) 450-3986
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 3138 (MN)

Record details

NPI number1376348185
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 17, 2025
Last updated in NPPESApril 14, 2025
Certification dateApril 14, 2025
Mailing addressPo Box 47159, Plymouth, MN 55447-0159

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Metropolitan Anesthesia Network Llp — 519 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Plymouth