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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

STACIE JACKSON, PA

Active

STACIE JACKSON, PA is a Surgical Physician Assistant healthcare provider located in JACKSONVILLE, Florida. NPI 1770248668 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · JACKSONVILLE, FL

Registration Details

NPI Number
1770248668
Provider Type
Individual
Gender
Female
NPI Issued
Nov 4, 2021 (4.8015380461861 yrs)
Last Updated
Mar 10, 2025
Licenses
9115246 (FL)
PA9115246 (FL)

Practice Information

Address
3627 UNIVERSITY BLVD S STE 550
JACKSONVILLE, FL, 322167401
Browse FL providers · Browse ZIP 32216
Phone
9043795986
Primary Specialty
Surgical Physician Assistant
363AS0400X
Additional Specialty
Surgical Physician Assistant

Other Surgical Physician Assistant Providers in JACKSONVILLE, FL

Name Credential NPI
JAMES A ARRECHE PA-C 1548264393
SHERRI ANN ROBERTS PA-C 1124022975
KRIS H STIPE PA-C 1770587545
NOEL MASTERS PERRY 1871597567
CARLTON R MCCARTHY 1205830908
TAMMEZA GIBSON PA 1972502268
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.