MRS. JESSICA BERDETTE JACKSON (NPI# 1205335916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205335916 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA BERDETTE JACKSON |
| Other Name | MS. JESSICA BERDETTE SULLIVAN |
| Credential | LPN |
| Practice Address |
376 Owego Rd Candor NY 13743-1645 |
| Practice Telephone | 6073726591 |
| Mailing Telephone | 6073726591 |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-02-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 298757 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759594 | Jessica Ashley Jackson | Social Worker | 310 W Mckinley Ave, Mishawaka, IN 46545-5600 | 2020-10-28 |
| 1396387361 | Jessica Leeann Jackson | In Home Supportive Care | 2643 Portsmouth Pl, Hephzibah, GA 30815-6434 | 2019-10-11 |
| 1720638018 | Jessica Jackson | Registered Nurse | 1600 Pine Tree Rd Apt 415, Longview, TX 75604-3244 | 2019-09-18 |
| 1386106326 | Jessica Marie Jackson | Specialist/Technologist | 120 Main St Apt 217, Saco, ME 04072-3528 | 2019-04-01 |
| 1023553187 | Jessica Elise Jackson | Physician Assistant | 2109 S Santa Fe Ave, Moore, OK 73160-2807 | 2016-12-28 |
| 1982151130 | Jessica Jackson | Licensed Practical Nurse | 25 Green Knolls Dr Apt D, Rochester, NY 14620-4777 | 2016-09-06 |
| 1770940975 | Jessica Jackson | Technician, Other | 24024 Evergreen Rd Apt 108a, Southfield, MI 48075-5517 | 2016-01-20 |
| 1710344007 | Jessica Jackson | Social Worker | 4 Tufts Trl, Hopatcong, NJ 07843-1013 | 2016-01-18 |
| 1336572726 | Jessica L Jackson | Health Educator | 492 Naughright Rd, Long Valley, NJ 07853-3807 | 2013-08-20 |
| 1619216850 | Jessica Lindsay Jackson | Specialist/Technologist | 2905 River Rd, Redfield, AR 72132-9105 | 2013-02-07 |
| Street Address |
376 OWEGO RD |
| City | CANDOR |
| State | NY |
| Zip Code | 13743-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912275686 | Kristen Lynn Tompkins | Registered Nurse | 2 Academy St, Candor Elementary School, Candor, NY 13743 | 2011-12-08 |
| 1740411669 | Visut Prasarn | Pediatrics | 615 Owego Rd, Candor, NY 13743 | 2009-07-28 |
| 1871563908 | Mark Erwin Glosenger | Emergency Medicine | 54 Main Street, Candor, NY 13743 | 2006-01-23 |
| 1306312145 | Samantha Dinse | Registered Nurse | 54 Main St, Candor, NY 13743 | 2018-10-19 |
| 1528541869 | Lexandria Pascarella | Physician Assistant | 54 Main St, Candor, NY 13743 | 2018-09-12 |
| 1265989586 | Colby Westervelt | Specialist/Technologist | 1 Academy Street, Candor, NY 13743 | 2016-09-02 |
| 1336500727 | Kezia Marshall | Registered Nurse | 2 Academy Street, Candor, NY 13743 | 2016-03-11 |
| 1508071754 | Stephen Cleve Scarseth | Nurse Practitioner | 54 Main St, Candor, NY 13743 | 2007-05-11 |
| 1518953082 | Michael F Murphy | Family Medicine | 54 Main St, Candor, NY 13743 | 2005-09-21 |
| 1669467858 | James Skiff | Family Medicine | 54 Main St, Candor, NY 13743 | 2005-09-14 |
| Find all providers in zip 13743 | ||||
| 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 |
|---|---|---|---|---|
| 1952716243 | Sara Lee Tennant | Licensed Practical Nurse | 21 Bank St, Candor, NY 13743-1511 | 2014-06-25 |
| 1629257886 | Jillanne Jane Parillo | Licensed Practical Nurse | 76 Howard Hill Rd, Candor, NY 13743-2124 | 2007-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780503 | Michael Lee Hendryx | Licensed Practical Nurse | 803 Bell St, Olean, NY 14760-3005 | 2020-11-06 |
| 1720689664 | Chynna S Brown | Licensed Practical Nurse | 483 Newbury St, Rochester, NY 14615-3209 | 2020-11-06 |
| 1588265433 | Deanna Lucas | Licensed Practical Nurse | 206 Prospect Pl, Bay Shore, NY 11706-1537 | 2020-11-06 |
| 1659972511 | Katiesianna Marie Kovalsky | Licensed Practical Nurse | 718 Griswold Hts, Troy, NY 12180-5168 | 2020-11-05 |
| 1538760608 | Shanequa Marshall | Licensed Practical Nurse | 100 Park Ave Apt 1, Amityville, NY 11701-3165 | 2020-11-05 |
| 1780285007 | Jarleyn Severino | Licensed Practical Nurse | 10 Waterview Pl, Lynbrook, NY 11563-1921 | 2020-11-03 |
| 1023619590 | Lisa A Loomis | Licensed Practical Nurse | 2198 Us Highway 20, Nassau, NY 12123-1733 | 2020-11-02 |
| 1235739061 | Kathleen Zalamea | Licensed Practical Nurse | 37 Howells Rd, Bay Shore, NY 11706-6502 | 2020-10-30 |
| 1649870494 | Khairat Salami | Licensed Practical Nurse | 1538 Washington Ave Apt 1, Bronx, NY 10457-8334 | 2020-10-30 |
| 1518567437 | Catherine Grullon | Licensed Practical Nurse | 32 Crescent Ave, Newburgh, NY 12550-3134 | 2020-10-29 |
| 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.