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

Tana Jackson-Wilson

Individual provider Licensed Practical Nurse · NPI 1639504152

Tana Jackson-Wilson is a Licensed Practical Nurse in Phoenix, Arizona. Licensed in Arizona and Illinois. Registered with an NPI since 2013.

Licensed in
AZ, IL
In the registry since
2013
Specialties on file
2

Practice location Address checks out

4612 N 28th St Camelback Hs Medically Fragile
Phoenix, AZ 85016-4931
Phone: (602) 764-7122
Show map & directions

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

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence LP048815 (AZ)
Licensed Practical Nurse Taxonomy 164W00000X · Licence 043114639 (IL)

Record details

NPI number1639504152
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 4, 2013
Last updated in NPPESSeptember 4, 2013
Mailing address4612 N 28th St, Camelback Hs Medically Fragile, Phoenix, AZ 85016-4931

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