Individual provider · Type 1 NPI

Lee Douglas Jackson, NP-C

Family Nurse Practitioner · Fort Myers, FL

NPI number 1053602102 Active

Practice location

16271 Bass Rd
Fort Myers, FL 33908-3616

Call (239) 343-7100 Map

Fax (239) 468-7924

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147

Other practice locations

  • 214 W 1st St, Cle Elum, WA 98922-1108 · (509) 674-6779
  • 9131 College Pointe Ct, Fort Myers, FL 33919-3245 · (239) 343-9100

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XAP60602473 (WA)
Nurse Practitioner 363L00000XAP60602473 (WA)
Family Nurse Practitioner 363LF0000X2011003377 (MO)
Family Nurse Practitioner Primary 363LF0000XAPRN11027444 (FL)
Family Nurse Practitioner 363LF0000X5375350071 (KS)

Family Nurse Practitioner: Definition to come...

25 other providers at this address

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About NPI 1053602102

Lee Douglas Jackson, NP-C's National Provider Identifier is 1053602102, issued on Apr 25, 2011. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fort Myers, FL. The record was last updated on May 27, 2026.