NPI age
7 years
Enumerated 2019-03-18
● Active
Type 1 · Individual
Lyle Jeremy Jackson, CRNA
Jackson is 1 of 1 registered nurse providers in Idaho Falls and 1 of 5 in Idaho.
Primary specialty
Registered Nurse
Plus 2 subspecialties
Licensed in
ID, VA, IA
3 states
Status
Active
No deactivations on record
Last NPPES update
2025-06-30
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 5 active registered nurse providers in Idaho.
NPI age
7 years
↓ 12 yr below median (19 yr)
State licenses
3 states
Top 80% — 20% of peers are multi-state
Subspecialties
1
In the 20% of peers with subspecialties
NPI lifetime · 2019 → 2026
2019-03Enumerated in NPPES
2019
2026
Where they practice
Practice location
2325 Coronado St
Idaho Falls, ID 834047407
Mailing address
1090 Barney Dairy Rd
Rexburg, ID 834403542
Specialties
-
Registered Nurse PrimaryDefinition to come...
-
Nurse Anesthetist, Certified Registered(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
Practice context
Part of a multi-provider practice. 55 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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