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Individual
LEE DOUGLAS JACKSON
Active
Individual
LEE DOUGLAS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60602473
WA
363LF0000X
Family Nurse Practitioner
2011003377
MO
363LF0000X
Family Nurse Practitioner
5375350071
KS
363LF0000X
Family Nurse Practitioner
AP60602473
WA
363LF0000X
Family Nurse Practitioner
Primary
APRN11027444
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121013000
—
FL
Enumeration date
04/25/2011
Last updated
05/27/2026
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