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

Marley Jackson, NP

Individual provider Nurse Practitioner · NPI 1730079310

Marley Jackson, NP is a Nurse Practitioner in Saint Peters, Missouri. Qualified in 2025, 1 year ago. Practices with Fairview Heights Medical Group SC, a 448-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2025
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

70 Jungermann Cir Ste 300
Saint Peters, MO 63376-1637
Phone: (636) 916-7060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2025018317 (MO)

Record details

NPI number1730079310
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedJuly 7, 2025
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025
Mailing addressPo Box 959354, Saint Louis, MO 63195-9354

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Fairview Heights Medical Group Sc — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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