Individual
GLENDA ELIZABETH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
12225 71ST ST, KENOSHA, WI 53142-7320
(877) 666-7223
(262) 948-4871
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
16452
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
16452-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100310731
—
WI
05
—
100310882
—
WI
Enumeration date
12/30/2015
Last updated
06/25/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us