Individual provider · Type 1 NPI

Roseann Jacks, CPNP-PC

Pediatric Nurse Practitioner · Albuquerque, NM

NPI number 1225746795 Active

Practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Call (505) 272-5928 Map

Fax (505) 272-6620

Mailing address

4816 Mcmahon Blvd NW, Apt K88
Albuquerque, NM 87114

Other practice locations

  • 8308 Constitution Pl NE, Albuquerque, NM 87110-7637 · (505) 883-9570

Specialties and licenses

TaxonomyCodeLicense
Case Management Registered Nurse 163WC0400XR49577 (NM)
Pediatric Nurse Practitioner Primary 363LP0200X90358 (NM)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1225746795

Roseann Jacks, CPNP-PC's National Provider Identifier is 1225746795, issued on Nov 14, 2022. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Albuquerque, NM. The record was last updated on Nov 2, 2026.