Individual provider · Type 1 NPI

Samantha Rae Jackson, FNP-BC

Family Nurse Practitioner · Collinsville, IL

NPI number 1861960221 Active

Practice location

320 Sumner Blvd
Collinsville, IL 62234-1929

Call (618) 514-1170 Map

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209017975 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1861960221

Samantha Rae Jackson, FNP-BC's National Provider Identifier is 1861960221, issued on Nov 5, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Collinsville, IL. The record was last updated on Nov 5, 2018.