HOLLY JEAN JACKSON (NPI# 1417351453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417351453 |
| Entity Type | Individual |
| Full Name | HOLLY JEAN JACKSON |
| Credential | LPN |
| Practice Address |
5a Lafayette Avenue Canandaigua NY 14424 |
| Practice Telephone | 5859051307 |
| Mailing Telephone | 5859051307 |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 308910 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275802 | Holly Marie Jackson | Technician | 448 W Cooper St, Tipton, MO 65081-8217 | 2020-11-04 |
| 1689156721 | Holly Alegro Jackson | Non-emergency Medical Transport (VAN) | 10550 Murat Dr, Saint Louis, MO 63136-4524 | 2018-09-05 |
| 1013212711 | Holly Jackson | Social Worker | 511 W 86th Ter, Kansas City, MO 64114-2822 | 2011-01-11 |
| 1083882278 | Holly Jackson | Licensed Practical Nurse | 2040 Murray Holladay Rd Ste 205, Salt Lake City, UT 84117-5197 | 2008-02-11 |
| 1548753700 | Holly Jean Jackson | Behavior Technician | 19800 Village Office Ct, Bend, OR 97702-1872 | 2018-06-12 |
| 1922596220 | Holly Suzanne Jackson | Counselor | 1100 Walnut St, Owensboro, KY 42301-2956 | 2018-04-23 |
| 1720575392 | Holly Jackson | Nurse Anesthetist, Certified Registered | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-04-18 |
| 1427576511 | Holly M Jackson | Nurse Practitioner | 905 Dixie St, Carrollton, GA 30117-4417 | 2017-09-08 |
| 1427597301 | Holly Jackson | Registered Nurse | 1109 Jones St, Kennett, MO 63857-3824 | 2017-02-13 |
| 1023551223 | Holly V Jackson | Advanced Practice Midwife | 1900 S Tuttle Ave, Sarasota, FL 34239-3114 | 2016-11-21 |
| Street Address |
5A LAFAYETTE AVENUE |
| City | CANANDAIGUA |
| State | NY |
| Zip Code | 14424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725029 | Stefanie Ann Hook | Nurse Practitioner | 395 West Street, Suite 101, Canandaigua, NY 14424 | 2019-11-21 |
| 1285120618 | Mary Kathleen Woodruff | Counselor | 163 Gibson Street, Canandaigua, NY 14424 | 2018-07-09 |
| 1699260612 | Victoria Record | Nurse Practitioner | 3325 Marvin Sands Dr, Canandaigua, NY 14424 | 2018-06-22 |
| 1649767443 | Liana Irene Schenk | Counselor | 5297 Parkside Drive, Building 400, Suite 408, Canandaigua, NY 14424 | 2018-04-17 |
| 1225534019 | Brook Slaby | Counselor | 5297 Parkside Dr Building 400 Office 411, Canandaigua, NY 14424 | 2018-04-02 |
| 1154839710 | Madasyn Leigh Smith | Physical Therapist | 229 Parrish St Ste 220, Canandaigua, NY 14424 | 2018-01-17 |
| 1295259992 | Melissa Ann Frarey | Licensed Practical Nurse | 4998 Wyffels Road, Canandaigua, NY 14424 | 2017-08-03 |
| 1235674599 | Wendy Williams | Early Intervention Provider Agency | 5145 North Bloomfiled Road, Canandaigua, NY 14424 | 2016-12-22 |
| 1326418252 | Mary Christine Casella | Registered Nurse | 90 West Gibson Street, Canandaigua, NY 14424 | 2015-10-05 |
| 1629314935 | Tialin Marie Hines | Occupational Therapist | 5415 North Bloomfield Road, Canandaigua, NY 14424 | 2012-12-14 |
| Find all providers in zip 14424 | ||||
| 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 |
|---|---|---|---|---|
| 1669025995 | Meredith Susan Matson | Licensed Practical Nurse | 125 Grove Dr Apt 15b, Canandaigua, NY 14424-1682 | 2019-07-16 |
| 1417446485 | Debra Grace Newcombe | Licensed Practical Nurse | 3832 Middle Cheshire Rd, Canandaigua, NY 14424-8333 | 2018-05-05 |
| 1295259992 | Melissa Ann Frarey | Licensed Practical Nurse | 4998 Wyffels Road, Canandaigua, NY 14424 | 2017-08-03 |
| 1518318336 | Karrie Hogle | Licensed Practical Nurse | 427 N Main St Apt 7, Canandaigua, NY 14424-1039 | 2016-06-22 |
| 1063868917 | Jennifer Boyce | Licensed Practical Nurse | 2301 Mcintyre Rd, Canandaigua, NY 14424-7927 | 2016-05-10 |
| 1336507045 | Veronica Kulak-erdle | Licensed Practical Nurse | 5760 Smith Rd, Canandaigua, NY 14424-8927 | 2016-02-09 |
| 1578933941 | Kim Rodriguez | Licensed Practical Nurse | 29 W Gibson St, Canandaigua, NY 14424-1411 | 2015-09-29 |
| 1457743098 | Cynthia Carestio | Licensed Practical Nurse | 152 Stewart Pl, Canandaigua, NY 14424-1163 | 2015-02-18 |
| 1508256017 | Heather Fosco | Licensed Practical Nurse | 3388 Hopkins Rd, Canandaigua, NY 14424-9337 | 2015-02-04 |
| 1952708554 | Dawn Kneut | Licensed Practical Nurse | 4467 Middle Cheshire Rd, Canandaigua, NY 14424-8327 | 2014-11-25 |
| Find all providers in CANANDAIGUA | ||||
| City | CANANDAIGUA |
| Zip Code | 14424 |
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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.