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

Glenda Elizabeth Jackson, RN

Individual provider Nurse Practitioner · NPI 1205291572

Glenda Elizabeth Jackson, RN is a Nurse Practitioner in Kenosha, Wisconsin. Qualified in 2024, 2 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
2
Licensed in
WI
In the registry since
2015
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

12225 71st St
Kenosha, WI 53142-7320
Phone: (877) 666-7223
Fax: (262) 948-4871
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4126 N 16th St, Milwaukee, WI 53209-6915 — (414) 544-2882

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 16452-33 (WI)
Nurse Practitioner Taxonomy 363L00000X · Licence 16452 (WI)

Record details

NPI number1205291572
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedDecember 30, 2015
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Kenosha