CONCRAIGRETTA JACKSON (NPI# 1932741451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932741451 |
Entity Type | Individual |
Full Name | CONCRAIGRETTA JACKSON |
Practice Address |
21124 Behrendt Ave Warren MI 48091-2774 |
Practice Telephone | 3137432278 |
Enumeration Date | 2019-10-16 |
Last Update Date | 2019-10-16 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 164W00000X | Licensed Practical Nurse | 4703121283 | MI | Nursing Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
21124 Behrendt Ave, Warren, MI 480912774 | 3137432278 |
Street Address |
21124 BEHRENDT AVE |
City | WARREN |
State | MI |
Zip Code | 48091-2774 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548615172 | Amanda Lynn Kelsey | Nurse Practitioner | 21647 Ryan Road, Warren, MI 48091 | 2016-05-02 |
1902284474 | Daejana Maldonado | Licensed Practical Nurse | 7519 Toepfer, Warren, MI 48091 | 2015-05-15 |
1245637743 | Jerami Roy | Recreation Therapist | 7086 E 9 Mile, Warren, MI 48091 | 2014-11-26 |
1265698344 | Amanda Sarah Yousif-mansour | Dentist | 2442 E 10 Mile Road, Warren, MI 48091 | 2008-07-29 |
1326171166 | Sunshine Dental Center PC | Dentist | 21761 Ryan Rd, Warren, MI 48091 | 2007-03-13 |
1487709630 | Albert Spickers | General Practice | 26193 Meredith Drive, Warren, MI 48091 | 2007-01-25 |
1487706859 | Rita Jean Rose | Physician Assistant | 2104 E. 11 Mile Road, Suite 600, Warren, MI 48091 | 2007-01-17 |
1790835452 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 2000 Ten Mile Rd., Warren, MI 48091 | 2007-01-12 |
1942363759 | Carolyn Joan Sucaet | Physical Therapist | 20952 12 Mile Road, Suite 110, St. Clair Shores, FM 48091 | 2006-12-19 |
1013070135 | Mcnichols Xray Clinic PC | Radiology | 21230 Dequindre Road, Southeast Michigan Surgical Hospital, Warren, MI 48091 | 2006-12-19 |
Find all providers in zip 48091 |
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 |
---|---|---|---|---|
1437788536 | Kathy Diane Garland | Licensed Practical Nurse | 3805 Lyntz Townline Rd Sw, Warren, OH 44481-9213 | 2020-04-02 |
1861026395 | Bianca Symone-raveen Morris | Licensed Practical Nurse | 24629 Berry Ave, Warren, MI 48089-2170 | 2020-02-24 |
1417516170 | Jasmin Marie Dahl | Licensed Practical Nurse | 159 Linden Ave Se, Warren, OH 44483-5921 | 2019-06-06 |
1043877368 | Jamie Ryan | Licensed Practical Nurse | 687 Melwood Dr Ne, Warren, OH 44483-4437 | 2019-05-22 |
1164911244 | Keenan Tenant | Licensed Practical Nurse | 28241 Gilbert Dr, Warren, MI 48093-2625 | 2018-05-04 |
1710474820 | Courtney Mabins | Licensed Practical Nurse | 21135 La Salle Blvd, Warren, MI 48089-3414 | 2018-04-16 |
1003334889 | Stephanie T Turuck | Licensed Practical Nurse | 1900 Sandpiper Trl Se, Warren, OH 44484-5712 | 2017-08-31 |
1790213650 | Joyce A Mechling | Licensed Practical Nurse | 2737 Youngstown Rd., Warren, OH 44484 | 2017-05-23 |
1386178473 | Theresa Mccoy | Licensed Practical Nurse | 13029 Georgiana Ave, Warren, MI 48089-3279 | 2017-04-14 |
1316488323 | Ebone L Talley | Licensed Practical Nurse | 2779 Merriweather St Nw, Warren, OH 44485-2508 | 2017-03-10 |
Find all providers in WARREN |
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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.