NIKKITA JACKSON


Address: 454 Westchester Avenue, Port Chester, NY 10573
Phone: 9143510650

NIKKITA JACKSON (NPI# 1023627288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023627288
Entity Type Individual
Full Name NIKKITA JACKSON
Practice Address 454 Westchester Avenue
Port Chester
NY 10573
Practice Telephone 9143510650
Mailing Telephone 9143510650
Enumeration Date 2020-07-23
Last Update Date 2020-07-23
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WM0705X Registered Nurse
Specialization: Medical-Surgical
788484 NY Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY N/A 131740445 01

Office Location

Street Address 454 WESTCHESTER AVENUE
City PORT CHESTER
State NY
Zip Code 10573

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568091676 Jessica Michelle Cabrera-guzhnay Counselor One Gateway Plaza St.3b, Port Chester, NY 10573 2020-04-02
1275036436 Vernon Z Harris Massage Therapist Rye Brook Physical Medicine and Rehabilitation PC, 14 Rye Ridge Plaza Suite 238, Rye Brook, NY 10573 2018-03-14
1750825303 Christopher Petrowski Contractor 310 Locust Avenue, Port Chester, NY 10573 2016-12-15
1457808974 Rye Ridge Pharmacy Inc Pharmacy 146 S. Ridge Street, Rye Brook, NY 10573 2016-09-01
1841646270 Jill Brookman Specialist 124 Country Ridge Drive, Rye Brook, NY 10573 2016-05-04
1396128963 Madhulika Priya Advani Dentist 118 South Ridge St, Suite 5, Rye Brook, NY 10573 2015-07-01
1407254063 Mirzana Calhoun Licensed Practical Nurse 411 Westchester Ave 1-c, Port Chester, NY 10573 2014-12-15
1053734038 Marvin Israel Matz Otolaryngology 60 Doral Greens Drive West, Rye Brook, NY 10573 2014-01-28
1932520392 Beth Woodtli Counselor 12 Jean Lane, Rye Brook, NY 10573 2014-01-02
1902240518 Ekaterina Castano Pathology 10 Pearl St Fl 4, Port Chester, NY 10573 2013-04-25
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Taxonomy Information

Taxonomy Code 163WM0705X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Medical-Surgical

Taxonomy Definition

Definition to come...

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Competitor

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City PORT CHESTER
Zip Code 10573

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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