KEYSHA JACKSON (NPI# 1245891555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245891555 |
| Entity Type | Individual |
| Full Name | KEYSHA JACKSON |
| Practice Address |
5135 Camino Al Norte # 115 North Las Vegas NV 89031-2387 |
| Mailing Address |
770 W Lone Mountain Rd North Las Vegas NV 89031-3008 |
| Practice Telephone | 7025060681 |
| Mailing Telephone | 7029808782 |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Street Address |
5135 CAMINO AL NORTE # 115 |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89031-2387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295213775 | Sheila O'neal | Rehabilitation Practitioner | 5135 Camino Al Norte # 115, North Las Vegas, NV 89031-2387 | 2018-08-06 |
| 1285295584 | Danielle L Degraffenreid | Technician | 5135 Camino Al Norte # 115, North Las Vegas, NV 89031-2387 | 2019-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265071039 | Dimuro Facilities Services | Pain Medicine | Dimuro Pain Management, 3970 W Ann Road Ste 100, N Las Vegas, NV 89031 | 2019-12-27 |
| 1225681323 | Jasmine Coleman | Home Health Aide | 1517 Santa Rosalia Dr., North Las Vegas, NV 89031 | 2019-07-18 |
| 1558924134 | Jamie Esprecion | Driver | 3007 Extravagant Ave, North Las Vegas, NV 89031 | 2019-04-18 |
| 1831652387 | Assured Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 4461 North Decatur Blvd, Ste 110, N Las Vegas, NV 89031 | 2019-04-11 |
| 1265928550 | Geraldine Alford | Chore Provider | 5150 El Camino Norte Suite 150, Las Vegas, NV 89031 | 2018-07-10 |
| 1861999468 | Danielle Anderson | Counselor | 4528 West Craig Suite 150, Las Vegas, NV 89031 | 2018-04-10 |
| 1871094078 | Ethel Richardson | Chore Provider | 620 Manuel Edwardo Ave, N. Las Vegas, NV 89031 | 2018-02-22 |
| 1124547997 | Crystal Dorin Mcdowell | Counselor | 5920 Palmilla St Unit 5, North Las Vegas, NV 89031 | 2017-09-13 |
| 1699293308 | Mitzi Darnell Adeyemi | Counselor | 2205 Mountain Sunset Ave, North Las Vegas, NV 89031 | 2017-09-01 |
| 1831629500 | Emily Davis | Case Manager/Care Coordinator | 1926 La Villa Dr, North Las Vegas, NV 89031 | 2017-06-15 |
| Find all providers in zip 89031 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093072 | Nakia T Newson | Technician | 3033 Little Crimson Ave, North Las Vegas, NV 89081-6584 | 2020-11-04 |
| 1972101673 | Yamileth Abicely Flores Molina | Technician | 4422 Scarlet Sea Ave, North Las Vegas, NV 89031-0454 | 2020-10-14 |
| 1942807714 | Mark Dela Vega | Technician | 2913 Vigilante Ct, North Las Vegas, NV 89081-6401 | 2020-10-05 |
| 1780295410 | Shanethia Mcneal | Technician | 5210 Rock Cabin Ct, North Las Vegas, NV 89031-3422 | 2020-08-14 |
| 1023629532 | Christopher Farley | Technician | 2212 Dale Bumpers Ct, North Las Vegas, NV 89081-2679 | 2020-08-10 |
| 1407466279 | Sylvia Ruacho | Technician | 2720 Holmes St, North Las Vegas, NV 89030-5428 | 2020-08-05 |
| 1255941274 | Marissa Elizabeth Nunez | Technician | 2105 Broken Twig Ct, North Las Vegas, NV 89032-0704 | 2020-08-04 |
| 1417567801 | Daniela Mendiola | Technician | 414 Violetta Ave, North Las Vegas, NV 89031-1785 | 2020-07-31 |
| 1548879265 | Jodi Knecht | Technician | 3216 Stanley Ave, North Las Vegas, NV 89030-7230 | 2020-07-28 |
| 1770101834 | Generson Cruz Manubay | Technician | 6916 Fox Sparrow Ct, North Las Vegas, NV 89084-2072 | 2020-07-06 |
| Find all providers in NORTH LAS VEGAS | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89031 |
Please comment or provide details below to improve the information on KEYSHA 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.