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Samantha Rae Jackson, FNP-BC
Family Nurse Practitioner in Collinsville, Illinois
NPI 1861960221

Samantha Rae Jackson is a Family Nurse Practitioner based in Collinsville, IL and is specialized in Family. Samantha Rae Jackson practices in Collinsville, IL and has the professional credentials of FNP-BC. The NPI Number for Samantha Rae Jackson is 1861960221 and holds a License No. 209017975 (Illinois).

The current practice location address for Samantha Rae Jackson is 320 Sumner Blvd, Collinsville, IL and can be reached out via phone at 618-514-1170.

Location: 320 Sumner Blvd, Collinsville, IL, 62234-1929
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861960221
Provider Name
Samantha Rae Jackson
Credential
FNP-BC
Provider Entity Type
Individual
Gender
Female
Address
320 Sumner Blvd, Collinsville, IL, 62234-1929
Phone Number
618-514-1170
Fax Number
Provider Enumeration Date
11/05/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
320 Sumner Blvd
City
Collinsville
State
Illinois
Zip
62234-1929
Phone Number
618-514-1170
Fax Number
person
Provider Business Mailing Address Details
Address
320 Sumner Blvd
City
Collinsville
State
Illinois
Zip
62234-1929
Phone Number
618-514-1170
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209017975 (Illinois)
Definition
Definition to come...
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