NICOLE DANIELLE JACKSON (NPI# 1255592754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255592754 |
| Entity Type | Individual |
| Full Name | NICOLE DANIELLE JACKSON |
| Credential | MS, ATC, CSCS |
| Practice Address |
5300 Pacific Ave Se Lacey WA 98503-7500 |
| Mailing Address |
2213 Sw Siskin Cir Port Orchard WA 98367-6200 |
| Practice Telephone | 3604384536 |
| Practice Fax Number | 3604384568 |
| Mailing Telephone | 3604384536 |
| Mailing Fax Number | 3604384568 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699184689 | Nicole Jackson | Specialist | 3983 Thunder Heights Ln, Middleburg, FL 32068-7362 | 2014-08-05 |
| 1053745521 | Nicole L Jackson | Counselor | 3394 Mckelvey Rd Ste 116, Bridgeton, MO 63044-2531 | 2013-09-02 |
| 1245569276 | Nicole Denise Jackson | Licensed Practical Nurse | 2122 Ridge Rd W, Rochester, NY 14626-2802 | 2009-12-22 |
| 1144559931 | Nicole L Jackson | Licensed Practical Nurse | 18680 Main Street, Tontogany, OH 43565 | 2009-12-08 |
| 1144489261 | Nicole L. Jackson | Counselor | 6815 W Capitol Dr Ste 304, Milwaukee, WI 53216-2056 | 2008-06-04 |
| 1124299680 | Nicole Jackson | Licensed Practical Nurse | 1830 Southern Pkwy, Springfield, OH 45506-3115 | 2008-03-12 |
| 1578740023 | Nicole Jackson | Counselor | 3630 George Washington Hwy, Ste B-6, Yorktown, VA 23693 | 2008-01-28 |
| 1205999588 | Nicole Lewis Jackson | Dentist | 3298 Northside Dr, Macon, GA 31210 | 2006-12-18 |
| 1104447275 | Nicole Feliz Jackson | Specialist/Technologist | 1301 S Us Highway 377, Argyle, TX 76226-7744 | 2020-04-30 |
| 1023637220 | Nicole Jackson | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-04-09 |
| Street Address |
5300 PACIFIC AVE SE |
| City | LACEY |
| State | WA |
| Zip Code | 98503-7500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144250408 | Dana K Roberts | Specialist/Technologist | 5300 Pacific Ave Se, Lacey, WA 98503-7500 | 2006-07-03 |
| 1457622391 | Rachel Lynne Sherburne | Specialist/Technologist | 5300 Pacific Ave Se, Lacey, WA 98503-7500 | 2012-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457838989 | Michele Nordgren Bourque | Psychologist | 4329 Concordia Lane Se, Lacey, WA 98503 | 2018-07-26 |
| 1831638675 | Trevor John Marum | Chiropractor | 3945 8th Ave Se, Lacey, WA 98503 | 2017-02-13 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1144683616 | Millenda Thomas | Registered Nurse | 1233 Firpark Dr. S.e., Lacey, WA 98503 | 2016-04-01 |
| 1609257245 | Erika Charlotte Vonkotzebue | Counselor | 4401 37th Ave. Se #25, Lacey, WA 98503 | 2015-06-09 |
| 1437576196 | Candy Nelson | Registered Nurse | 4410 6th Ave Se, Apt# 115, Lacy, WA 98503 | 2014-03-19 |
| 1134563919 | Alvin Fitzgerald | Pharmacist | 665 Sleater Kinney Rd., S.e, Target Pharmacy #1355, Lacey, WA 98503 | 2013-04-23 |
| 1518200724 | Katherine Mary Marsh | Psychologist | 5191 Corporate Center Court Se, Lacey, WA 98503 | 2013-04-05 |
| 1740530906 | Leanna Marie Mcbroom | Massage Therapist | 1608 Diamond Loop Se, Lacey, WA 98503 | 2012-09-14 |
| 1831445196 | Joyce Emily Christensen Coniff | Counselor | 5706 39th Ave Se., Lacey, WA 98503 | 2012-07-24 |
| Find all providers in zip 98503 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023638889 | Rebekah Mattes | Specialist/Technologist | 6436 Juliann Ct Se, Lacey, WA 98513-6525 | 2020-04-22 |
| 1467986125 | Rachel Montgomery | Specialist/Technologist | 3524 Radcliff Ct Se, Lacey, WA 98503-6238 | 2017-04-19 |
| 1184048688 | Stephanie Renee Hjortedal | Specialist/Technologist | 8750 Tallon Lane Ne., Lacey, WA 98516 | 2014-02-05 |
| 1477673978 | William V Slosson | Specialist/Technologist | 350 River Ridge Dr Se, Lacey, WA 98513-6830 | 2007-03-29 |
| 1598806788 | Alice Renee Loebsack | Specialist/Technologist | 5000 Abbey Way Se, Lacey, WA 98503 | 2007-02-09 |
| 1144250408 | Dana K Roberts | Specialist/Technologist | 5300 Pacific Ave Se, Lacey, WA 98503-7500 | 2006-07-03 |
| 1447772900 | Kayla Marie Clauson | Specialist/Technologist | 4740 Avery Ln Se, Lacey, WA 98503-5603 | 2017-07-16 |
| 1134598949 | Ramzy Assaf | Specialist/Technologist | 5000 Abbey Way Se, Lacey, WA 98503-3200 | 2015-09-22 |
| 1457622391 | Rachel Lynne Sherburne | Specialist/Technologist | 5300 Pacific Ave Se, Lacey, WA 98503-7500 | 2012-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990329 | Tina Daniels | Specialist/Technologist | 5104 W Nob Hill Blvd Apt 8, Yakima, WA 98908-5814 | 2020-10-25 |
| 1902405079 | Sara Danielle Holey | Specialist/Technologist | 24048 Se 111th St, Issaquah, WA 98027-8320 | 2020-10-20 |
| 1265049902 | Erin L Rose | Specialist/Technologist | 510 Nw Larry St, Pullman, WA 99163-3584 | 2020-09-27 |
| 1790392629 | William Bratton | Specialist/Technologist | 26222 119th Dr Se, Kent, WA 98030-7882 | 2020-09-24 |
| 1790392611 | Carli Grace Robins | Specialist/Technologist | 3654 Nw Cascade Ave, East Wenatchee, WA 98802-9570 | 2020-09-24 |
| 1164039079 | Jalyn Rutledge | Specialist/Technologist | Bohler Athletic Complex Cougar Way - Wsu, Pullman, WA 99164-0001 | 2020-09-24 |
| 1356957054 | Alex Vincent Pham | Specialist/Technologist | 3523 Se 176th Ave, Vancouver, WA 98683-3591 | 2020-09-17 |
| 1063030583 | Elizabeth Kakos | Specialist/Technologist | 528 Pontius Ave N Unit 431, Seattle, WA 98109-5821 | 2020-07-10 |
| 1396369708 | Kristin Marie Mikolajewski | Specialist/Technologist | 116 247th Ave Se, Sammamish, WA 98074-3444 | 2020-06-01 |
| 1437773033 | Mckaleb Pool | Specialist/Technologist | 10777 Grafton Pl Nw, Silverdale, WA 98383-8941 | 2020-05-31 |
| 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.