HOLLY MARIE JACKSON (NPI# 1689275802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689275802 |
| Entity Type | Individual |
| Full Name | HOLLY MARIE JACKSON |
| Other Name | HOLLY MARIE PARDOE |
| Practice Address |
448 W Cooper St Tipton MO 65081-8217 |
| Practice Telephone | 5733531292 |
| Mailing Telephone | 5733531292 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689156721 | Holly Alegro Jackson | Non-emergency Medical Transport (VAN) | 10550 Murat Dr, Saint Louis, MO 63136-4524 | 2018-09-05 |
| 1417351453 | Holly Jean Jackson | Licensed Practical Nurse | 5a Lafayette Avenue, Canandaigua, NY 14424 | 2014-10-20 |
| 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 |
448 W COOPER ST |
| City | TIPTON |
| State | MO |
| Zip Code | 65081-8217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326105248 | Ronald Lamar Shuler | Dentist | 303 South Osage St, Tipton, MO 65081 | 2007-01-02 |
| 1871077297 | Lianne Twyman | Pharmacist | 875 Hwy 5 South, Tipton, MO 65081 | 2018-09-21 |
| 1306051255 | Ralph Marion Stonner | Dentist | 849 Countryside Ln., Tipton, MO 65081-0238 | 2007-05-14 |
| 1952795692 | Donna June Bell | Nurse Practitioner | 806 S Fork Ln, Tipton, MO 65081-4005 | 2015-03-19 |
| 1538155742 | N & R of Tipton, LLC | Skilled Nursing Facility | 601 W Morgan St, Tipton, MO 65081-8214 | 2005-09-22 |
| 1427063072 | Ssm Regional Health Services | Pharmacy | 875 Hwy 5 South, Tipton, MO 65081-8253 | 2006-07-30 |
| 1124235866 | Mid-mo Ambulance District | Ambulance | 221 S Moreau Ave, Tipton, MO 65081-8257 | 2007-05-16 |
| 1265563126 | Janet Marie Miller | Speech-Language Pathologist | 727 Saddler Dr, Tipton, MO 65081-8292 | 2007-03-09 |
| 1326254285 | Bristol Care, Inc. | Assisted Living Facility | 908 Park Ave, Tipton, MO 65081-8408 | 2007-05-15 |
| 1588601777 | Ssm Regional Health Services | Clinic/Center | 875 State Route 5, Tipton, MO 65081-8441 | 2006-05-31 |
| Find all providers in zip 65081 | ||||
| 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 |
|---|---|---|---|---|
| 1043819519 | Joice Westfall-hollingsworth | Technician | 3530 Greenwood Blvd Ste A, Maplewood, MO 63143-4211 | 2020-10-25 |
| 1952909798 | A 2nd Family LLC | Technician | 3507 Southern Hills Dr, Kansas City, MO 64137-2119 | 2020-10-14 |
| 1295343127 | Ardella Watkins | Technician | 3878 Hirondelle Ln, Florissant, MO 63034-2308 | 2020-07-16 |
| 1538784459 | Rita D Wilson | Technician | 9597 Jacobi Ave Bldg 33 Apt 7, Saint Louis, MO 63136 | 2020-06-16 |
| 1386269769 | Bev Emery | Technician | 22820 Sw Hampton Ct, Blue Springs, MO 64015-9624 | 2020-06-11 |
| 1346870664 | Honor Cds LLC | Technician | 7918 Delmar Blvd # A, Saint Louis, MO 63130-3715 | 2020-01-26 |
| 1922646728 | Eduhealth Personal Care Services | Technician | 5843 Eagle Valley Dr Saint Louis Mo 63136, Saint Louis, MO 63136 | 2019-12-12 |
| 1265075600 | Lisa Gaye Adamson | Technician | 36 County Road 331, Poplar Bluff, MO 63901-5478 | 2019-10-17 |
| 1417508060 | Ca Home Health Care Services LLC | Technician | 2216 Normandy Dr, Saint Louis, MO 63121-4732 | 2019-09-25 |
| 1104473750 | Healing Waters of St Louis LLC | Technician | 1670 Horseshoe Dr, Florissant, MO 63033-2526 | 2019-08-19 |
| Find all providers with the same taxonomy | ||||
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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.