Individual
REBECCA SUZANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 297-2200
(770) 534-8139
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 534-8998
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
APRN-CNM136000
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004732
AMERIGROUP
GA
01
—
340852
WELLCARE
GA
05
—
382185596A
—
GA
05
—
382185596D
—
GA
05
—
382185596E
—
GA
05
—
382185596G
—
GA
Enumeration date
06/13/2006
Last updated
10/30/2025
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