JADE BRETTNEY JACKSON PMHNP NPI 1790540631

NPI Information

  • NPI: 1790540631
  • Provider Name: JADE BRETTNEY JACKSON, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4310 METRO PKWY STE 205
    FORT MYERS, FL
    ZIP 33916
  • Phone: (239) 690-6906

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NPI Details

Jade Brettney Jackson, PMHNP is a psychiatric/mental health nurse practitioner in Fort Myers, FL with 2 years of experience. Jade Brettney Jackson, PMHNP NPI is 1790540631. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4310 METRO PKWY STE 205
FORT MYERS, FL
ZIP 33916-416
Phone: (239) 690-6906

The NPI 1790540631 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/20/2024 and was last updated on 8/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered NurseRN9426818FLORIDANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health11033263FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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