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MRS. POLLY REBECCA JACKSON AG-ACNP
NPI 1790150688
Nurse Practitioner - Acute Care in Washington, MO

Active since December 03, 2015
901 E 5TH ST, WASHINGTON, MO 63090(636) 239-8231 Get Directions Write a Review

NPPES record last updated: October 25, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 25, 2022, Dec 3, 2015 (2 updates tracked since 2015).

About Mrs. Polly Rebecca Jackson Ag-acnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. POLLY REBECCA JACKSON AG-ACNP (NPI 1790150688) is an individual acute care provider in Washington, Missouri, licensed in Missouri (2015041436) and active in the NPI registry since December 2015. She maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1790150688
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMRS. POLLY REBECCA JACKSONCredential: AG-ACNP
Location Address901 E 5TH STWashington, MO 63090-3127
Mailing Address901 E 5th StWashington, MO 63090-3127 · (636) 239-8231
Phone(636) 239-8231
Sole ProprietorNo
Enumeration DateDecember 3, 2015
Last NPPES UpdateOctober 25, 20222 updates tracked since enumeration
NPPES CertifiedOctober 25, 2022
✔ NPI 1790150688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in MO · 2015041436
901 E 5TH ST, Washington, MO 63090
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Secondary Practice Location 1

Location 1615 S New Ballas RdSaint Louis, MO 63141-8221 · Phone (314) 251-0175

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAYA PARKER MD
Internal Medicine
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 239-8231
REYNA SUHAIL TULAIS GUERRA RN
Registered Nurse (Maternal Newborn)
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 239-8500
BRANDON ROSENBERG MD
Emergency Medicine
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 239-8011
RASHID MAHMOOD QURESHI MD
Internal Medicine
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 239-8231
DR. DANIEL PAUL HOEHNE D.O.
Emergency Medicine
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 239-8000
MRS. MARILYN KAY WADE RD, LD
Dietitian, Registered
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 239-8744
SHANNON ELAINE HOLT PHARMD, BCPS
Pharmacist
901 E 5TH ST
WASHINGTON, MO 63090
Franklin County (636) 390-7227
ERIC V. A. MATLOCK D.O.
Family Medicine
901 E 5TH ST, MEDICAL STAFF OFFICE
WASHINGTON, MO 63090
Franklin County (636) 239-8231

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Polly Jackson's NPI number?

The NPI number for Polly Jackson is 1790150688. It was assigned to this individual provider in the NPPES registry on December 3, 2015.

Where is Polly Jackson located?

Polly Jackson practices at 901 E 5th St, Washington, MO 63090. The listed phone number is (636) 239-8231.

What is Polly Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

When was this NPI record last updated?

The NPPES record for Polly Jackson was last updated on October 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.