LATESHIA JACKSON (NPI# 1063840262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063840262 |
| Entity Type | Individual |
| Full Name | LATESHIA JACKSON |
| Practice Address |
8737 Brooks Dr Ste 108 Easton MD 21601-7474 |
| Mailing Address |
8142 Harold Ct Glen Burnie MD 21061-4960 |
| Practice Telephone | 8008672395 |
| Practice Fax Number | 4104434960 |
| Mailing Telephone | 2022533588 |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2019-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R193593 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Booth St, Elkton, MD 219215657 | 4109963400 | |
| 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21801 | 8008672395 | 4104430842 |
| 505 E Main St, Salisbury, MD 218045020 | 4103413420 | |
| 514 Poplar St, Cambridge, MD 216131834 | 8008672395 | 4104430842 |
| 8142 Harold Ct, Glen Burnie, MD 21061 | 2022533588 |
| Street Address |
8737 BROOKS DR STE 108 |
| City | EASTON |
| State | MD |
| Zip Code | 21601-7474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558612010 | Jessica Hart Bass | Counselor | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2012-09-25 |
| 1326680091 | Andrea Dixon | Social Worker | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2019-10-14 |
| 1235790783 | Daphime Jackson | Counselor | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2019-06-25 |
| 1902462427 | Lifes Energy Wellness Center Inc. | Counselor | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2019-05-10 |
| 1679139125 | Nicole Morris | Counselor | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2019-05-09 |
| 1811486962 | Lifes Energy Wellness Center Inc. | Registered Nurse | 8737 Brooks Dr Ste 108, Suite 108, Easton, MD 21601-7474 | 2018-05-04 |
| 1134636038 | Kathryn C Norman | Counselor | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2018-01-02 |
| 1477974277 | Andrea Maria Kelley-freeman | Counselor | 8737 Brooks Dr Ste 108, Easton, MD 21601-7474 | 2013-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588205215 | Jodi Windsor Kindt | Nurse Practitioner | Aamg Talbot Primary Care, 28438 Marlboro Avenue, Easton, MD 21601 | 2019-10-03 |
| 1902466998 | Christina Deleon | Physician Assistant | 403 Marvel Court, Easton, MD 21601 | 2019-06-20 |
| 1710458583 | Patricia Vilani | Occupational Therapy Assistant | 12 Magnolia, Easton, MD 21601 | 2018-12-05 |
| 1538687702 | Kristin Dabbs Wilkerson | Counselor | 29520 Canvasback Drive, Easton, MD 21601 | 2017-09-07 |
| 1356869978 | Angela Lynn Rutherford | Physical Therapy Assistant | 610 Dutchman's Ln, Easton, MD 21601 | 2017-09-04 |
| 1851842389 | Myeyedr Optometry of Maryland, LLC | Optometrist | 28522 Marlboro Ave, Ste A, Easton, MD 21601 | 2016-10-19 |
| 1659721991 | Lauren Strady | Pediatrics | 500 Cadmus Ln Ste 210, Easton, MD 21601 | 2016-06-17 |
| 1194174391 | Statcare Group IIi, PC | Clinic/Center | 28522-c Marlboro Avenue, Easton, MD 21601 | 2016-06-08 |
| 1245684224 | Christina M Ball | Nurse Practitioner | 545 Cynwood Drive, Easton, MD 21601 | 2016-04-15 |
| 1205220274 | Rebecca Ann Ruby Ailstock | Midwife | 508 Idlewild Ave Ste 3, Easton, MD 21601 | 2015-03-26 |
| Find all providers in zip 21601 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053951004 | Aisha Hassan-davis | Nurse Practitioner | 29520 Canvasback Dr, Easton, MD 21601-7124 | 2020-01-07 |
| 1063060515 | Catherine M Myers | Nurse Practitioner | 498 Washington St, Easton, PA 18042-4432 | 2019-08-28 |
| 1922503978 | Brenda L Soloe | Nurse Practitioner | 241 N 13th St, Easton, PA 18042-3211 | 2018-03-29 |
| 1144667957 | Teresa Callahan Hulseman | Nurse Practitioner | 29520 Canvasback Dr, Easton, MD 21601-7124 | 2013-06-03 |
| 1063777043 | Anastasia Leigh Tusa | Nurse Practitioner | 8614 Ocean Gtwy, Ste 4, Easton, MD 21601-7217 | 2012-07-06 |
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| 1992304372 | Catherine Koskei | Nurse Practitioner | 2295 Lowell Ridge Rd Apt B, Parkville, MD 21234-2370 | 2020-10-18 |
| 1194323857 | Meliora Davies | Nurse Practitioner | 206 Settlers Way, Upper Marlboro, MD 20774-5770 | 2020-10-14 |
| 1932707171 | David Mwangi | Nurse Practitioner | 27 Blue Spire Cir, Middle River, MD 21220-1743 | 2020-10-10 |
| 1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
| 1639776446 | Serenity Heart Healthcare, LLC | Nurse Practitioner | 6755 Business Pkwy Ste 304, Elkridge, MD 21075-6740 | 2020-10-05 |
| 1689281529 | Premier Psychiatry, LLC | Nurse Practitioner | 10601 Virginia Ave, Cockeysville, MD 21030-2315 | 2020-09-24 |
| 1407462559 | Mem Scepter Home & Behavioral | Nurse Practitioner | 14104 Dawn Whistle Way, Bowie, MD 20721-1304 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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| 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.