Provider Demographics
NPI:1992502686
Name:JACKSON, MEGAN D (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:D
Last Name:JACKSON
Suffix:
Gender:
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:D
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6939 FRIESENHAHN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78263-2329
Mailing Address - Country:US
Mailing Address - Phone:210-396-9541
Mailing Address - Fax:
Practice Address - Street 1:6939 FRIESENHAHN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78263-2329
Practice Address - Country:US
Practice Address - Phone:210-396-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191318363LF0000X
TX765814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse