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

Jennifer R Jack, CPNP

Individual provider Pediatric Nurse Practitioner · NPI 1184045148

Jennifer R Jack, CPNP is a Pediatric Nurse Practitioner in Fort Myers, Florida. Licensed in Florida and Indiana. Registered with an NPI since 2013.

Licensed in
FL, IN
In the registry since
2013
Specialties on file
3
What do these letters mean?
CPNP — Certified Pediatric Nurse Practitioner
A nurse practitioner certified in paediatrics.

See every abbreviation used in this directory →

Practice location Address checks out

15901 Bass Rd Ste 102
Fort Myers, FL 33908-3838
Phone: (239) 343-9890
Fax: (239) 343-9898
Show map & directions

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

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence APRN11019090 (FL)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 28148319A (IN)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 71004791A (IN)

Record details

NPI number1184045148
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP
Sole proprietorNo
NPI enumeratedDecember 18, 2013
Last updated in NPPESMay 3, 2022
Certification dateMay 3, 2022

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