Glenda Elizabeth Jackson
R.N. | Nurse Practitioner
12225 71st St, Kenosha
Wisconsin, 53142-7320
877-666-7223
Glenda Elizabeth Jackson is a Kenosha, Wisconsin based nurse practitioner. Active license number of Glenda Elizabeth Jackson is 16452-33 for Psych/Mental Health in Wisconsin. Her current practice location is 12225 71st St, Kenosha. Patients can reach her at 877-666-7223 or can fax her at 262-948-4871. Glenda Elizabeth Jackson is R.N. and her NPI number (Unique professional ID assigned by NPPES) is 1205291572.
Glenda Elizabeth Jackson has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Glenda Elizabeth Jackson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Glenda Elizabeth Jackson |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | R.N. |
| Practice Address: | 12225 71st St, Kenosha,
Wisconsin, 53142-7320 |
| Phone: | 877-666-7223 |
| Fax: | 262-948-4871 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1205291572 |
| NPI Enumeration Date: | 30 Dec, 2015 |
| NPI Last Update On: | 25 Jun, 2025 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Glenda Elizabeth Jackson are as mentioned below.
| License Number | Specialization | State | Status | |
| 16452-33 | Psych/Mental Health | Wisconsin | Primary | |
| 16452 | Nurse Practitioner | Wisconsin | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Glenda Elizabeth Jackson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 100310731 | Medicaid | Wisconsin | |
| 100310882 | Medicaid | Wisconsin | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Glenda Elizabeth Jackson
Po Box 735044,
Chicago, Illinois |
| Zip: | 60673-5044 |
| Phone Number: | 800-326-2250 |
Patients can reach Glenda Elizabeth Jackson at
12225 71st St, Kenosha, Wisconsin or can
call to book an appointment on 877-666-7223.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.