IndividualActive
Audrey Jackson, APRN
NPI 1114507332 · Primary Care Nurse Practitioner · Melbourne, FL
Provider details
- NPI number
- 1114507332
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- Yes
- License
- APRN11026952 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1223 Gateway Dr Ste 1d
Melbourne, FL 32901-2607
Phone: (321) 729-6166
Fax: (321) 722-1237
Approximate (ZIP-level) locationGet directions
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Additional practice locations (1)
- 3425 Bayside Lakes Blvd Se Ste 110Palm Bay, FL 32909-6867Phone: (321) 729-6166Fax: (321) 722-1237
Registry dates
- Enumerated
- 2021-04-12
- Last updated
- 2024-02-09
- Certified
- 2024-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.