Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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Kathleen Adele Jackson, AG-ACNP

Individual provider Acute Care Nurse Practitioner · NPI 1699108209

Kathleen Adele Jackson, AG-ACNP is a Nurse Practitioner in Saint Paul, Minnesota. Qualified in 2013, 13 years ago. Practices with Fairview Health Services, a 678-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
13
Licensed in
MN
In the registry since
2013
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Practice location Address checks out

1700 University Ave W Fl 6
Saint Paul, MN 55104-3727
Phone: (651) 232-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence R-169854-7 (MN)

Record details

NPI number1699108209
Entity typeIndividual (Type 1)
GenderFemale
Credentials AG-ACNP
Sole proprietorNo
NPI enumeratedAugust 19, 2013
Last updated in NPPESSeptember 25, 2018

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Fairview Health Services — 678 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients94
Services billed 290 a service is one billed item, such as a visit, a test or a procedure
Average patient age70

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Fairview Health Services

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 678 clinicians in the practice; 12 are shown here.

Other providers in Saint Paul