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

Jennifer Melissa Jackson, APRN

Individual provider Nurse Practitioner · NPI 1104603364

Jennifer Melissa Jackson, APRN is a Nurse Practitioner in Port Saint Lucie, Florida. Qualified in 2023, 3 years ago. Practices as a sole proprietor and works from 3 locations. Licensed in California and Florida.

Years since qualifying
3
Licensed in
CA, FL
In the registry since
2023
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.

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Practice location Address checks out

1850 SW Fountainview Blvd Ste 105
Port Saint Lucie, FL 34986-4527
Phone: (772) 336-2818
Fax: (772) 336-5313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 24422 Avenida De La Carlota Ste 300, Laguna Hills, CA 92653-3628 — (949) 599-2434
  • 650 Howe Ave Ste 100, Sacramento, CA 95825-4732 — (916) 924-9337

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN11028311 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence 95038498 (CA)

Record details

NPI number1104603364
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorYes
NPI enumeratedSeptember 12, 2023
Last updated in NPPESFebruary 16, 2026
Certification dateFebruary 16, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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