person
Audrey Lee Farson Jackson, APRN
Primary Care Nurse Practitioner in Melbourne, Florida
NPI 1114507332

Audrey Lee Farson Jackson is a Primary Care Nurse Practitioner based in Rockledge, FL and is specialized in Primary Care. Audrey Lee Farson Jackson practices in Melbourne, FL and has the professional credentials of APRN. The NPI Number for Audrey Lee Farson Jackson is 1114507332 and holds a License No. APRN11026952 (Florida).

The current practice location address for Audrey Lee Farson Jackson is 1223 Gateway Dr Ste 1D, Melbourne, FL and can be reached out via phone at 321-729-6166 and via fax at 321-722-1237. You can also correspond with Audrey Lee Farson Jackson through the mailing address at 3300 S FISKE BLVD, ROCKLEDGE, FL - 32955-4306 (mailing address contact number: 321-729-6166).

Location: 1223 Gateway Dr Ste 1D, Melbourne, FL, 32955-4306
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Provider Profile Details
NPI Number
1114507332
Provider Name
Audrey Lee Farson Jackson
Credential
APRN
Provider Entity Type
Individual
Gender
Female
Address
1223 Gateway Dr Ste 1D, Melbourne, FL, 32955-4306
Phone Number
321-729-6166
Fax Number
321-722-1237
Provider Enumeration Date
04/12/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
SA065 01 FL MEDICARE HF
120782400 05 FL
institution
Provider Business Practice Location Address Details
Address
1223 Gateway Dr Ste 1D
City
State
Zip
32901-2607
Phone Number
321-729-6166
Fax Number
321-722-1237
person
Provider Business Mailing Address Details
Address
1223 Gateway Dr Ste 1D
City
State
Zip
32901-2607
Phone Number
321-729-6166
Fax Number
321-722-1237
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
APRN11026952 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Obstetrics & Gynecology
Taxonomy
License No.
APRN11026952 (Florida)
Definition
Definition to come...
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