MR. ROBERT ALAN JACKSON (NPI# 1114076882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114076882 |
| Entity Type | Individual |
| Full Name | MR. ROBERT ALAN JACKSON |
| Credential | R.N., FNP-C |
| Practice Address |
120 E Beauregard Ave San Angelo TX 76903-5919 |
| Mailing Address |
4707 Teakwood Trce Midland TX 79707-1636 |
| Practice Telephone | 3254812247 |
| Practice Fax Number | 3254812307 |
| Mailing Telephone | 4325221567 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP112515 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
655208 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701487 | Robert Jackson | Physical Therapist | 3056 Healthy Way Ste 116, Birmingham, AL 35243-2435 | 2019-10-11 |
| 1881003655 | Robert Donald Jackson | Social Worker | 151 Knollcroft Rd # 116d, Lyons, NJ 07939-5001 | 2014-08-06 |
| 1780005496 | Robert Earl Jackson Jr. | Community Health Worker | 17 Wickham Dr, Columbus, GA 31907-6328 | 2013-12-23 |
| 1073942371 | Robert Jackson | Massage Therapist | 502 11th St Se, Decatur, AL 35601-4908 | 2013-11-06 |
| 1447548573 | Robert Joseph Jackson | Licensed Practical Nurse | 5454 East State St, Hermitage, PA 16148 | 2011-07-11 |
| 1457515330 | Robert Anthony Jackson | Dentist | 2816 Veach Rd., Unit 305, Owensboro, KY 42303 | 2008-07-10 |
| 1437357399 | Robert D Jackson | Counselor | 5525 Erindale Dr Ste 112, Colorado Springs, CO 80918-6960 | 2007-07-03 |
| 1174736029 | Robert Allan Jackson | Physician Assistant | 2109 Brookview Ter Apt B, Pekin, IL 61554-7320 | 2007-05-08 |
| 1144389347 | Robert W Jackson | Dentist | 209 Mimosa Dr, Thomasville, GA 31792-6633 | 2006-12-06 |
| 1144305152 | Robert Eric Jackson | Internal Medicine | 291 Indian Lake Blvd, Hendersonville, TN 37075-3653 | 2006-10-26 |
| Street Address |
120 E BEAUREGARD AVE |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76903-5919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921459 | Ernest Charlesworth | Dermatology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2005-06-01 |
| 1093349359 | Michael T Mcenrue | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2020-02-26 |
| 1194298596 | Rachel J Reyes | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2019-01-08 |
| 1649746512 | Jessica Orona | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2018-10-18 |
| 1770960312 | Dawn Empey | Registered Nurse | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2015-05-04 |
| 1639573231 | Eduardo Jose Gonzalez | Internal Medicine | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2014-10-10 |
| 1043626518 | Emily Michelle Dodd | Anesthesiology | 120 E Beauregard Ave, San Angelo, TX 76903 | 2014-07-06 |
| 1487080479 | Melissa P Hohensee | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2013-09-23 |
| 1003168055 | Maegin M Carlile | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2012-10-15 |
| 1760746325 | Kristi D. Urias | Anesthesiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2012-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
| 1154782415 | Jerrica Elayne Escobedo | Counselor | 424 South Oakes, San Angelo, TX 76903 | 2016-03-15 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1821475161 | San Angelo Dental, Pllc | Dentist | 614 29th Street, Suite, Sanangelo, TX 76903 | 2015-05-06 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1295087294 | Tara Joiner | Counselor | 27 W Beauregard Ave, San Angelo, TX 76903 | 2012-10-15 |
| 1225380728 | Tanya L Favor | Physician Assistant | 215 E. College, San Angelo, TX 76903 | 2012-10-08 |
| 1336459551 | Education Service Center | Social Worker | 612 S Irene, San Angelo, TX 76903 | 2010-10-21 |
| 1508194176 | Pay and Save Inc | Pharmacy | 1926 N. Bryant Blvd., San Angelo, TX 76903 | 2009-11-19 |
| 1326375734 | Pay and Save Inc | Pharmacy | 2 S. Main St., San Angelo, TX 76903 | 2009-11-05 |
| Find all providers in zip 76903 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992515 | Stacie A Gregg | Nurse Practitioner | 1229 Johnny Ln, San Angelo, TX 76905-2331 | 2020-11-07 |
| 1487269064 | Delilah Deguire-guerra | Nurse Practitioner | 143 Oakwood St, San Angelo, TX 76903-8631 | 2020-09-10 |
| 1215571914 | Dawn Cumbie Burwick | Nurse Practitioner | 431 W 34th St, San Angelo, TX 76903-2323 | 2019-11-05 |
| 1033767504 | Kate Elizabeth Young | Nurse Practitioner | 1621 Iowa Ave, San Angelo, TX 76904-6888 | 2019-08-28 |
| 1760034698 | Lisbet Ivicic | Nurse Practitioner | 351 Kearney Blvd, San Angelo, TX 76908-3215 | 2019-07-11 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1487096665 | Mary Beth Luttrell | Nurse Practitioner | 1610s Chadbourne St, San Angelo, TX 76903-8510 | 2013-07-29 |
| 1336490614 | Toyha Drew Harper | Nurse Practitioner | 1601 S Chadbourne St, San Angelo, TX 76903-8509 | 2012-09-26 |
| 1992944565 | Kathe Ann Conner | Nurse Practitioner | 1901 Johnson St, San Angelo, TX 76909-0001 | 2009-02-05 |
| 1083859946 | David Earl Cooper | Nurse Practitioner | 1825 Christoval Rd, San Angelo, TX 76903-8602 | 2008-12-06 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
Please comment or provide details below to improve the information on MR. ROBERT ALAN JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.