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

Individual provider Adult Health Nurse Practitioner · NPI 1639202336

Tina Marie Jackson, ANP is a Nurse Practitioner in Cary, North Carolina. Qualified in 1999, 27 years ago. Practices with Wakemed Specialists Group LLC, a 869-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
27
Licensed in
NC
In the registry since
2007
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Practice location Address checks out

300 Keisler Dr Ste 204
Cary, NC 27518
Phone: (919) 233-0059
Fax: (919) 233-0343
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 900192 (NC)

Record details

NPI number1639202336
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP
Sole proprietorNo
NPI enumeratedMarch 13, 2007
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Wakemed Specialists Group Llc — 869 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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