BRENDA ANN JACKSON (NPI# 1326273707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326273707 |
| Entity Type | Individual |
| Full Name | BRENDA ANN JACKSON |
| Practice Address |
100 Lake Traverse Dr Sisseton SD 57262-7046 |
| Mailing Address |
Po Box 651 Agency Village SD 57262-0651 |
| Practice Telephone | 6056987606 |
| Mailing Telephone | 6056987606 |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2009-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538653498 | Brenda Jean Jackson | Technician | 807 Dillon Ave, New Aiken, SC 29801 | 2018-06-14 |
| 1205225349 | Brenda Lee Jackson | Nurse Practitioner | 757 W Eisenhower Rd, Lansing, KS 66043-2215 | 2015-01-13 |
| 1467631556 | Brenda Sue Jackson | Case Manager/Care Coordinator | 2508 S.e. 20th, Bentonville, AR 72712 | 2007-10-25 |
| 1588179501 | Brenda Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2017-12-13 |
| 1083060610 | Brenda L.e. Jackson | Occupational Therapist | 601 W Leota St, North Platte, NE 69101-6525 | 2016-05-12 |
| 1578972600 | Brenda Rene Jackson | Counselor | 1555 E Flamingo Rd, Ste. # 158, Las Vegas, NV 89119-5258 | 2014-08-01 |
| 1538509526 | Brenda Jackson | Behavioral Analyst | 5135 Camino Al Norte, Suite 255, North Las Vegas, NV 89031-2387 | 2013-07-05 |
| 1215372644 | Brenda Lee Jackson | Registered Nurse | 530 Hornady Dr, Monroeville, AL 36460-8658 | 2013-04-29 |
| 1336295286 | Brenda A L Jackson | Nurse Practitioner | 45-602 Kamehameha Hwy, Kaneohe, HI 96744-2017 | 2007-01-25 |
| 1922042951 | Brenda D Jackson | Nurse Practitioner | 1600 Coit Rd Ste 104, Plano, TX 75075-6171 | 2006-06-16 |
| Street Address |
100 LAKE TRAVERSE DR |
| City | SISSETON |
| State | SD |
| Zip Code | 57262-7046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689672248 | Harvey H Baker | Nurse Practitioner | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2005-07-08 |
| 1275143315 | Kayley Perkins | Pharmacist | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2020-08-04 |
| 1518575174 | Lindsay Dawn Peterson | Nurse Practitioner | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2020-07-20 |
| 1629692868 | Patricia Nicole Roth | Counselor | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2020-06-03 |
| 1306487475 | Leah Lorena Federico Rumans | Registered Nurse | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2019-09-30 |
| 1437718616 | Sherrie Renae Lee | Registered Nurse | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2019-06-11 |
| 1942770078 | Jennifer Elizabeth Hanson | Nurse Practitioner | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2018-12-02 |
| 1376037721 | Jaimi Lynn Pochant | Nurse Practitioner | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2018-06-19 |
| 1790274074 | Ferdinand Ekwutosi Enudu | Nurse Practitioner | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2018-05-02 |
| 1881102010 | Jasmine Shanae Hypolite | Registered Nurse | 100 Lake Traverse Dr, Sisseton, SD 57262 | 2018-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780149864 | Lewis Family Drug, LLC | Pharmacy | 925 Sd Hwy 10, Sisseton, SD 57262 | 2019-02-04 |
| 1346734696 | Sisseton-wahpeton Oyate | Private Vehicle | 12554 Bia Hwy 711, Agency Village, SD 57262 | 2018-06-20 |
| 1902106925 | Deborah Pauline Francis | Pharmacist | 1712 Sd Hwy 12, Pamida Pharmacy, Sisseton, SD 57262 | 2010-10-25 |
| 1508001322 | Trina Marie Cleveland | Registered Nurse | 44942 125th Street, Sisseton, SD 57262 | 2008-12-08 |
| 1467427625 | John Thomas Zimmer | Dentist | 100 Lake Traverse Drive, Sisseton, SD 57262 | 2006-02-21 |
| 1720634132 | Leah Adele Weiss | Pharmacist | 100 Lake Traverse Drive, Attn: Pharmacy, Sisseton, SD 57262 | 2019-08-12 |
| 1568906808 | Joshua S Satlak | Pharmacist | 100 Lake Traverse Drive, Sisseton, SD 57262 | 2016-12-06 |
| 1205278579 | Katie Elaine Bragg | Registered Nurse | 100 Lake Traverse Drive, Wwkmhcc Indian Health Service, Sisseton, SD 57262 | 2013-07-26 |
| 1497070080 | James Brian Moeller | Spec/Tech, Pathology | 100 Lake Traverse Drive, Sisseton, SD 57262 | 2010-04-07 |
| 1619063757 | Valinda Jeanne Redwing White | Nutritionist | 100 Lake Traverse Drive, Sisseton, SD 57262 | 2006-10-05 |
| Find all providers in zip 57262 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851726376 | Jennifer Marie Fuhr | Radiologic Technologist | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2013-09-04 |
| 1730419557 | Elijah John Wolfe | Radiologic Technologist | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2009-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992024137 | Jackalyn Spry | Radiologic Technologist | 4500 E Hwy 18, Pine Ridge, SD 57770 | 2010-05-27 |
| 1205096682 | Patrick Mcfarland | Radiologic Technologist | 420 4th St Ne Ste 122, Watertown, SD 57201-2658 | 2008-06-10 |
| 1770513475 | Mitchell Diagnostic | Radiologic Technologist | 2250 N Kimball St Ste 600, Mitchell, SD 57301-5335 | 2006-07-05 |
| 1508263690 | Monica Hanson | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2014-12-04 |
| 1447577580 | Kami H Wolf | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2010-04-29 |
| 1831416973 | Debra M Meyers | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2010-04-29 |
| 1871810911 | Sherry L Langstaff | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2010-04-29 |
| 1154581536 | Daniel Berg | Radiologic Technologist | 420 4th St Ne Ste 122, Watertown, SD 57201-2658 | 2008-06-10 |
| 1043470420 | Craig Pulling | Radiologic Technologist | 420 4th St Ne Ste 122, Watertown, SD 57201-2658 | 2008-06-10 |
| 1295940385 | David Dean Stimpson | Radiologic Technologist | 111 Washington Ave Nw, Wagner, SD 57380 | 2007-05-11 |
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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.