MS. SERIDA MARIE JACKSON


Address: 106 Countisbury Ave, Valley Stream, NY 11580-1748
Phone: (516) 270-0943

MS. SERIDA MARIE JACKSON (NPI# 1154841120) 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) 1154841120
Entity Type Individual
Full Name MS. SERIDA MARIE JACKSON
Credential LPN
Practice Address 106 Countisbury Ave
Valley Stream
NY 11580-1748
Practice Telephone (516) 270-0943
Mailing Telephone 5162700943
Enumeration Date 2017-06-21
Last Update Date 2017-06-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 164W00000X Licensed Practical Nurse 328081 NY Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY 124742419 05

Office Location

Street Address 106 COUNTISBURY AVE
City VALLEY STREAM
State NY
Zip Code 11580-1748

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942807276 Jason Diana Lmsw Clinic/Center 50 West Hawthorne Ave 2nd Floor, Valley Stream, NY 11580 2020-10-09
1346853033 R.l. Physical Therapy Physical Therapist 1676 Putney Road, Valley Stream, NY 11580 2020-08-24
1427523869 Jessica Doyle Social Worker 5-11 Pflug Pl, Valley Stream, NY 11580 2018-10-12
1013491026 Syeda Afshan Firdous Licensed Practical Nurse 13 Cleaveland St, Valley Stream, NY 11580 2018-09-17
1700377934 Jisha Merin Mathew Nurse Practitioner 1835 Oliver Ave, Apt 4, Valley Stream, NY 11580 2018-05-23
1669970273 Terrice Bell Social Worker 50 W Hawthorne Avenue, Valley Streams, NY 11580 2018-01-29
1659883718 Rita M. Fowler Registered Nurse 33 West Hawthorne Ave. Suite 31, New York Health Care, Valley Stream, NY 11580 2017-10-30
1881104768 Sharon Stephenson Peer Specialist 51 Foster Avenue, North Valley Stream, Valley Stream, NY 11580 2017-10-05
1356850200 Barry Henderson Case Manager/Care Coordinator 23 Marlow Road, Valley Stream, NY 11580 2017-09-22
1922526565 Aneta Kaczmarski Physical Therapy Assistant 299 North Corona Ave, Valley Stream, NY 11580 2017-09-05
Find all providers in zip 11580

Taxonomy Information

Taxonomy Code 164W00000X
Grouping Nursing Service Providers
Classification Licensed Practical Nurse

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295373769 Lisa Mcfaddin-robinson Licensed Practical Nurse 40 Liberty Blvd, Valley Stream, NY 11580-4834 2019-12-16
1437792579 Shellon Pryce Licensed Practical Nurse 106 E Beverly Pkwy, Valley Stream, NY 11580-4238 2019-10-22
1477104016 Yoldie Francois Licensed Practical Nurse 44 Spring Garden St, Valley Stream, NY 11580-3523 2019-09-25
1952872681 Samanta Boursiquot Licensed Practical Nurse 7 Bismark Ave, Valley Stream, NY 11581-1455 2018-12-06
1013491026 Syeda Afshan Firdous Licensed Practical Nurse 13 Cleaveland St, Valley Stream, NY 11580 2018-09-17
1194206292 Pierre Monsanto Licensed Practical Nurse 1300 Barry Dr S, Valley Stream, NY 11580-1542 2018-08-27
1477031953 Evris Shepard Licensed Practical Nurse 136 Roberta St, Valley Stream, NY 11580-2724 2018-08-06
1962997692 Julia Hannah Gbondo Licensed Practical Nurse 159 Carroll Ave, Valley Stream, NY 11580-2977 2018-06-25
1184134595 Davon Franklin Licensed Practical Nurse 1835 Oliver Ave Apt 1, Valley Stream, NY 11580-1603 2017-10-11
1821508995 Shanil Bahadur Licensed Practical Nurse 39 Ivanhoe Pl, Valley Stream, NY 11580-2901 2017-10-03
Find all providers in VALLEY STREAM

Competitor

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City VALLEY STREAM
Zip Code 11580

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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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