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

MS. Samala Jackson, CRNP

Individual provider Gerontology Nurse Practitioner · NPI 1184362600

MS. Samala Jackson, CRNP is a Nurse Practitioner in Berwyn, Pennsylvania. Qualified in 2017, 9 years ago. Practices with Vpa PC, a 182-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
9
Licensed in
PA
In the registry since
2022
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

1055 Westlakes Dr Ste 3152
Berwyn, PA 19312-2410
Phone: (215) 346-6050
Fax: (215) 220-3562
Show map & directions

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

Additional practice locations (2)

  • 9200 Bustleton Ave Apt 1705, Philadelphia, PA 19115-4230 — (215) 760-6386
  • 3621 Aramingo Ave Ste 5c, Philadelphia, PA 19134-4607 — (215) 444-7472

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence SP018935 (PA)

Record details

NPI number1184362600
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorYes
NPI enumeratedMay 24, 2022
Last updated in NPPESOctober 24, 2025
Certification dateOctober 24, 2025
Mailing addressPo Box 40412, Belfast, ME 04915-1255

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Vpa Pc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services