MONIQUE JACKSON (NPI# 1154606994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154606994 |
| Entity Type | Individual |
| Full Name | MONIQUE JACKSON |
| Credential | PHARMD |
| Practice Address |
6730 Bluffton Rd Fort Wayne IN 46809-2649 |
| Practice Telephone | 2607477563 |
| Mailing Telephone | 2607477563 |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2012-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26023015A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
| 1891178281 | Monique Jackson | Optometrist | 4205 Canal St, Ste B, New Orleans, LA 70119-5942 | 2015-07-02 |
| 1083973697 | Monique Lasean Jackson | Case Manager/Care Coordinator | 2910 Buford Dr, Apt# 702, Buford, GA 30519-5109 | 2012-05-16 |
| 1295026946 | Monique Jackson | Pharmacist | 1728 S Madison St, Whiteville, NC 28472-4934 | 2011-04-28 |
| 1295951291 | Monique Rochell Jackson | Nursing Care | 121 Oregon Ave, Ewing, NJ 08638 | 2007-04-18 |
| 1952338543 | Monique Rachelle Jackson | Nurse Practitioner | 1120 W. Washington Blvd., Los Angeles, CA 90015 | 2006-06-27 |
| 1114579208 | Monique Jackson | Counselor | 4410 W 13 Mile Rd, Royal Oak, MI 48073-6515 | 2019-07-10 |
| 1811482235 | Monique Jackson | Registered Nurse | 89 Bartlett St, Brooklyn, NY 11206-4463 | 2018-06-27 |
| 1427594092 | Monique Jackson | Social Worker | 9701 Philadelphia Ct Ste R, Lanham, MD 20706-4435 | 2017-01-06 |
| 1730622150 | Monique Kimberly Jackson | Social Worker | 8 Atwood Dr, Suite 301, Northampton, MA 01060-4266 | 2016-12-02 |
| Street Address |
6730 BLUFFTON RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46809-2649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851306971 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2006-07-29 |
| 1306323076 | Charles David Anderson | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2018-07-25 |
| 1184110389 | Sarah Beth Townsend | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2018-07-11 |
| 1780137687 | Hannah Denney | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2016-07-27 |
| 1316220494 | Ann Marie Miller | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2011-09-24 |
| 1740563030 | Alexandra Denise Moore Lijewski | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2011-09-22 |
| 1841573318 | Vicki Eileen Caccamo | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809 | 2011-09-21 |
| 1194008839 | Kathleen Anne Smith | Pharmacist | 6730 Bluffton Rd, Fort Wayne, IN 46809-2649 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497038574 | Zachary L Roberts | Pharmacist | 12279 Bluffton Road, Fort Wayne, IN 46809 | 2011-09-24 |
| 1679660278 | Kool Smiles In Ft. Wayne, PC | Dentist | 1852 Bluffton Road, Ft. Wayne, IN 46809 | 2006-10-06 |
| 1477512564 | Brian Thomas Raypole | Specialist/Technologist | 5050 N. Clinton Street, Fort Wayne, IN 46809 | 2006-03-20 |
| 1669016895 | Trinity Health Pharmacy Services, LLC | Pharmacy | 12279 Bluffton Road, Fort Wayne, IN 46809 | 2019-10-31 |
| 1871049981 | Mark Sexton | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809 | 2016-08-29 |
| 1104988112 | Karena Diane Schroeder | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809 | 2006-12-15 |
| 1013084946 | David L Kuhn | Physical Therapist | 3534 Brooklyn Ave, Fort Wayne, IN 46809 | 2006-11-29 |
| 1265588404 | May R. Dahman | Specialist | 1733 Kinsmoor Ave, Fort Wayne, IN 46809-1025 | 2007-01-27 |
| 1134746209 | Laurel Schroeder | Occupational Therapist | 1726 Bluffton Rd, Fort Wayne, IN 46809-1305 | 2020-07-06 |
| 1730793605 | Cody Craig | Physical Therapist | 1726 Bluffton Rd, Fort Wayne, IN 46809-1305 | 2020-09-08 |
| Find all providers in zip 46809 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1528677622 | Leslie Renee Siegel | Pharmacist | 11109 Parkview Plaza Dr # 1, Fort Wayne, IN 46845-1701 | 2020-07-24 |
| 1962048140 | Andrew Quang Tran | Pharmacist | 6202 Saint Joe Center Rd, Fort Wayne, IN 46835-2506 | 2019-11-21 |
| 1467005991 | Nicholas Selby | Pharmacist | 6220 Saint Joe Center Rd, Fort Wayne, IN 46835-2506 | 2019-07-23 |
| 1215427042 | Jerry Eugene Falls | Pharmacist | 9817 Chapmans Blvd, Fort Wayne, IN 46835-9194 | 2018-05-17 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1063900611 | Juliette Peters | Pharmacist | 1900 Carew St Ste 4, Fort Wayne, IN 46805-4765 | 2018-04-30 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1790238350 | Karleen Goodwin | Pharmacist | 3964 New Vision Dr, Fort Wayne, IN 46845-1712 | 2016-08-01 |
| 1699131300 | Brent Alan Losier | Pharmacist | 3537 N Anthony Blvd, Suite A, Fort Wayne, IN 46805-1423 | 2016-01-11 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46809 |
Please comment or provide details below to improve the information on MONIQUE JACKSON.
| 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.