Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jesse Lauren Pack, FNP-C

Individual provider Family Nurse Practitioner · NPI 1255098075

Jesse Lauren Pack, FNP-C is a Nurse Practitioner in Mesa, Arizona. Qualified in 2023, 3 years ago. Practices with Canyon Family Medicine PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
3
Licensed in
AZ
In the registry since
2021
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

6242 E Arbor Ave Ste 118
Mesa, AZ 85206-1309
Phone: (602) 805-4914
Fax: (602) 805-4917
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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 327183 (AZ)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 327183 (AZ)

Record details

NPI number1255098075
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedNovember 29, 2021
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025

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)
Group practice Canyon Family Medicine Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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