Audrey Lee Farson Jackson, APRN

Primary Care Nurse Practitioner · Melbourne, FL

Individual Active NPI

NPI number 1114507332

Practice location

1223 Gateway Dr Ste 1d
Melbourne, FL 32901-2607
Phone
(321) 729-6166
Fax
(321) 722-1237

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NPI record

NPI
1114507332
Entity type
Individual (Type 1)
Enumeration date
April 12, 2021
Last updated
February 9, 2024
Certified
February 9, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Primary Care Nurse Practitioner Primary 363LP2300X APRN11026952 FL
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN11026952 FL

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone
(321) 729-6166

Other practice locations (1)

  • 3425 Bayside Lakes Blvd SE Ste 110, Palm Bay, FL 32909-6867 · (321) 729-6166

About Audrey Jackson

Audrey Lee Farson Jackson, APRN is a healthcare provider registered in the NPI registry with the primary taxonomy Primary Care Nurse Practitioner (code 363LP2300X). The practice location is 1223 Gateway Dr Ste 1d, Melbourne, FL 32901-2607. The NPI number 1114507332 was assigned on April 12, 2021 and the record was last updated on February 9, 2024.

Audrey Jackson lists 2 licenses in the registry: #APRN11026952 (FL) for Primary Care Nurse Practitioner; #APRN11026952 (FL) for Obstetrics & Gynecology Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Audrey Lee Farson Jackson, APRN?

The NPI number is 1114507332.

What is the phone number of Audrey Jackson?

The phone number listed for the practice location is (321) 729-6166.

Where is Audrey Jackson located?

1223 Gateway Dr Ste 1d, Melbourne, FL 32901-2607.

What is the taxonomy code for Audrey Jackson?

The primary taxonomy code is 363LP2300X – Primary Care Nurse Practitioner; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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