Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jennifer R Jack, CPNP

Pediatric Nurse Practitioner in Fort Myers, FL · enumerated 2013.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1184045148

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Registry record

Entity type Individual (Type 1)

Name Jennifer R Jack

Credential CPNP

Sex Female

Practice address 15901 Bass Rd Ste 102, Fort Myers, FL, 33908

Phone (239) 343-9890

Fax (239) 343-9898

Enumeration date Dec 18, 2013

Last updated in NPPES May 3, 2022

Taxonomy & licenses

363LP0200X Pediatric Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 28148319A (IN) Secondary

363LP0200X Pediatric Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 71004791A (IN) Secondary

363LP0200X Pediatric Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License APRN11019090 (FL) Primary

Other identifiers

Identifier	Type	State	Issuer
113907600	Medicaid	FL	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How do I verify Jennifer Jack's NPI record?

Cross-check NPI 1184045148 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.

Is NPI 1184045148 active?

Yes, as of the latest NPPES snapshot, NPI 1184045148 is active (record last updated 2022-05-03).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-05-03.