Individual
COURTNEY ELYSE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 S CONGRESS AVE STE 104, AUSTIN, TX 78704-1776
(512) 275-6448
Mailing address
2508 SCOTTSVILLE RD STE 104, BOWLING GREEN, KY 42104-4400
(270) 746-6330
(270) 904-6337
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1021116
TX
363LF0000X
Family Nurse Practitioner
3013829
KY
Other
Enumeration date
04/01/2020
Last updated
05/12/2025
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