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

Mrs. Polly Rebecca Jackson, AG-ACNP

Individual provider Acute Care Nurse Practitioner · NPI 1790150688

Mrs. Polly Rebecca Jackson, AG-ACNP is an Acute Care Nurse Practitioner in Washington, Missouri. Works from 2 locations. Licensed in Missouri.

Licensed in
MO
In the registry since
2015

Practice location Address checks out

901 E 5th St
Washington, MO 63090-3127
Phone: (636) 239-8231
Show map & directions

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

Additional practice locations (1)

  • 615 S New Ballas Rd, Saint Louis, MO 63141-8221 — (314) 251-0175

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 2015041436 (MO)

Record details

NPI number1790150688
Entity typeIndividual (Type 1)
GenderFemale
Credentials AG-ACNP
Sole proprietorNo
NPI enumeratedDecember 3, 2015
Last updated in NPPESOctober 25, 2022
Certification dateOctober 25, 2022

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