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

Jacob Jackson, APRN, CNP

Individual provider Family Nurse Practitioner · NPI 1134629405

Jacob Jackson, APRN, CNP is a Nurse Practitioner in Elk City, Oklahoma. Qualified in 2017, 9 years ago. Practices with Farmers Union Hospital Association, a 43-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
9
Licensed in
OK
In the registry since
2018
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

1800 W 1st St Ste 105B
Elk City, OK 73644-3133
Phone: (580) 225-2518
Fax: (580) 225-3167
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 113330 (OK)
Medical-Surgical Registered Nurse Taxonomy 163WM0705X · Licence 113330 (OK)

Record details

NPI number1134629405
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN , CNP
Sole proprietorNo
NPI enumeratedFebruary 13, 2018
Last updated in NPPESMarch 26, 2020
Certification dateMarch 26, 2020
Mailing addressPo Box 2339, Elk City, OK 73648-2339

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Farmers Union Hospital Association — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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