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

Mrs. Shauntorya Jackson, AGNP

Individual provider Nurse Practitioner · NPI 1104296615

Mrs. Shauntorya Jackson, AGNP is a Nurse Practitioner in Flower Mound, Texas. Qualified in 2014, 12 years ago. Practices with Advanced Wound Care of North Texas PLLC, a 5-clinician group and offers telehealth. Licensed in Texas.

Years since qualifying
12
Licensed in
TX
In the registry since
2015
Specialties on file
2
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

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Practice location Address checks out

2281 Olympia Dr Ste 100
Flower Mound, TX 75028-1857
Phone: (469) 322-0089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence AP128145 (TX)
Nurse Practitioner Taxonomy 363L00000X · Licence AP128145 (TX)

Record details

NPI number1104296615
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP
Sole proprietorNo
NPI enumeratedSeptember 28, 2015
Last updated in NPPESJuly 5, 2023
Certification dateJuly 5, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Advanced Wound Care Of North Texas Pllc — 5 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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