STEPHANIE JACKSON (NPI# 1548601511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548601511 |
| Entity Type | Individual |
| Full Name | STEPHANIE JACKSON |
| Credential | LPN |
| Practice Address |
39 W. Yaphank Rd. Medford NY 11763 |
| Practice Telephone | 6313203077 |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 264400 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003459934 | Stephanie Denise Jackson | Respite Care | 22321 W Morning Glory St, Buckeye, AZ 85326-7181 | 2019-10-23 |
| 1821578006 | Stephanie M Jackson | Nurse Practitioner | 1350 Market Street, 1st Floor, Lynnfield, MA 01940 | 2018-08-17 |
| 1427538016 | Stephanie Renee Jackson | Occupational Therapist | 626 Colosseo Way, San Antonio, TX 78253-5687 | 2018-08-14 |
| 1376955294 | Stephanie Jackson | Behavioral Analyst | 6131 Alpine Tree Ave, Las Vegas, NV 89139-6854 | 2014-05-27 |
| 1134461361 | Stephanie K Jackson | Specialist | 1513 Sleepy Hollow Rd Unit A, Wenatchee, WA 98801-9132 | 2013-03-26 |
| 1073890828 | Stephanie Jackson | Massage Therapist | 3172 S Gilpin St, Englewood, CO 80113-3023 | 2011-11-08 |
| 1013177872 | Stephanie Colleen Jackson | Psychiatry & Neurology | 1950 Hope Valley Dr, Reno, NV 89521-3140 | 2008-06-13 |
| 1255512984 | Stephanie Brazeal Jackson | Nurse Practitioner | 711 Trestle Rd, Locust Grove, GA 30248-3465 | 2007-11-21 |
| 1992904155 | Stephanie Lynn Jackson | Dentist | 13521 Steelecroft Pkwy, Suite 100, Charlotte, NC 28278-7545 | 2007-07-17 |
| 1205045796 | Stephanie Andreya Jackson | Dental Hygienist | 801 Crestview Ave, Provo, UT 84604-4777 | 2007-05-21 |
| Street Address |
39 W. YAPHANK RD. |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| 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 |
|---|---|---|---|---|
| 1801496310 | Dyshonia Louise Dent | Licensed Practical Nurse | 1102 Lake Dr, Medford, NY 11763-4620 | 2020-10-26 |
| 1225635790 | Ashley Hartford | Licensed Practical Nurse | 94 Greenport Ave, Medford, NY 11763-3725 | 2020-10-07 |
| 1609407162 | Hannah Lynn Chapman | Licensed Practical Nurse | 244a Jamaica Ave, Medford, NY 11763-3237 | 2020-02-03 |
| 1376181040 | Jeimy Baez | Licensed Practical Nurse | 1001 Lake Dr, Medford, NY 11763-4618 | 2019-12-12 |
| 1326681032 | Ariel L. Barbour | Licensed Practical Nurse | 299 Southaven Ave, Medford, NY 11763-4332 | 2019-10-25 |
| 1821550526 | Shermille J Pascall | Licensed Practical Nurse | 5 Short St, Medford, NY 11763-4037 | 2019-04-02 |
| 1912486671 | Rachael Adejaiye | Licensed Practical Nurse | 39 Carr Ln, Medford, NY 11763-1070 | 2018-08-13 |
| 1598244238 | Chantal N Palomeque | Licensed Practical Nurse | 316 Peconic Ave, Medford, NY 11763-3549 | 2018-08-13 |
| 1033698121 | Laura Ruth Melilli | Licensed Practical Nurse | 1211 Wave Ave, Medford, NY 11763-1753 | 2018-08-09 |
| 1700375078 | Shawndel Minter | Licensed Practical Nurse | 125 Maple Ln, Medford, NY 11763-1027 | 2018-05-02 |
| Find all providers in MEDFORD | ||||
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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.