LISA JACKSON (NPI# 1154655488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154655488 |
| Entity Type | Individual |
| Full Name | LISA JACKSON |
| Credential | LPN |
| Practice Address |
2619 Product Dr Rochester Hills MI 48309-3807 |
| Practice Telephone | 2488449650 |
| Mailing Telephone | 2488449650 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703090363 | MI | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3062098 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| Street Address |
2619 PRODUCT DR |
| City | ROCHESTER HILLS |
| State | MI |
| Zip Code | 48309-3807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729814 | Sage Holdings Group, Ltd. | Nursing Care | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2005-06-09 |
| 1346574324 | Sylvia Nelson | Licensed Practical Nurse | 2619 Product Dr, Rochester Hills, MI 48309-3807 | 2009-09-24 |
| 1659605996 | Billie R Hale-thomas | Licensed Practical Nurse | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1265766505 | Kimberly Jo Falkner | Registered Nurse | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1922332279 | Robin Wood | Licensed Practical Nurse | 2619 Product Dr, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1396078622 | Angela Burton | Licensed Practical Nurse | 2619 Product Dr, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1124352463 | Michelle B Swinton | Licensed Practical Nurse | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1245564582 | Wanda Anita-nelson Cowan | Registered Nurse | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1881928125 | Denise Poole | Licensed Practical Nurse | 2619 Product Dr, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1861726101 | Theresa Lou Czarniak | Registered Nurse | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255874541 | Tracy Rutherford | Licensed Practical Nurse | 1613 Star Beit Drive, Rochester Hills, MI 48309 | 2016-11-18 |
| 1679016901 | Christian Ojimadu | Registered Nurse | 1613 Star-batt Drive, Rochester Hills, MI 48309 | 2016-11-18 |
| 1841749173 | Julian Alexander Prosser | Social Worker | 1800 Star Batt Drive, Rochester Hills, MI 48309 | 2016-09-28 |
| 1821472861 | Oakland University | Orthopaedic Surgery | 201 Athletics Ctr, Rochester, MI 48309 | 2015-07-18 |
| 1831438704 | Deborah Marie Tierney | Nurse Practitioner | 2200 Squirrel Road Human Health Building, Oakland University School of Nursing Room 2038, Rochester, MI 48309 | 2013-02-12 |
| 1396021242 | Karen Renee Farrar | Social Worker | 1344 Chestnut Cir, Rochester Hills, MI 48309 | 2011-10-24 |
| 1083922389 | Michigan V & P Management, LLC | Specialist | 1886 W. Auburn #300, Rochester Hills, MI 48309 | 2010-09-21 |
| 1689894032 | Steven L. Lipton Dds, PC | Dentist | 111 Rochdale Dr, Rochester Hills, MI 48309 | 2007-04-26 |
| 1083735773 | Jennifer R Haener | Family Medicine | 2940 Crooks Road, Rochester Hills, MI 48309 | 2007-04-02 |
| 1215079645 | Eva Colleen Frances Mondor | Counselor | 155 Rochdale Dr. S, Suite B, Rochester Hills, MI 48309 | 2007-02-13 |
| Find all providers in zip 48309 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558851964 | Christina Dobbs | Licensed Practical Nurse | 357 Devonshire Dr Apt 107, Rochester Hills, MI 48307-4020 | 2018-05-11 |
| 1255874541 | Tracy Rutherford | Licensed Practical Nurse | 1613 Star Beit Drive, Rochester Hills, MI 48309 | 2016-11-18 |
| 1710346440 | Nichole Sanday | Licensed Practical Nurse | 154 Brewster Rd, Rochester Hills, MI 48309-1433 | 2016-02-23 |
| 1477019636 | Clarissa Mellon | Licensed Practical Nurse | 1902 Star Batt Dr, Rochester Hills, MI 48309-3711 | 2019-02-13 |
| 1033610589 | Seth Aguinaga | Licensed Practical Nurse | 1902 Star Batt Dr, Rochester Hills, MI 48309-3711 | 2018-02-21 |
| 1285160135 | Tiffani Curtis | Licensed Practical Nurse | 1613 Star Batt Dr, Rochester Hills, MI 48309-3706 | 2017-05-11 |
| 1982158713 | Rhonda Thoman | Licensed Practical Nurse | 1613 Star Batt Dr, Rochester Hills, MI 48309-3706 | 2016-08-10 |
| 1346574324 | Sylvia Nelson | Licensed Practical Nurse | 2619 Product Dr, Rochester Hills, MI 48309-3807 | 2009-09-24 |
| 1659605996 | Billie R Hale-thomas | Licensed Practical Nurse | 2619 Product Dr, Suite 106, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| 1922332279 | Robin Wood | Licensed Practical Nurse | 2619 Product Dr, Rochester Hills, MI 48309-3807 | 2009-09-18 |
| Find all providers in ROCHESTER HILLS | ||||
| City | ROCHESTER HILLS |
| Zip Code | 48309 |
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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.