DIANA JACKSON (NPI# 1417498007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417498007 |
| Entity Type | Individual |
| Full Name | DIANA JACKSON |
| Credential | NP |
| Practice Address |
300 Main St Lewiston ME 04240-7027 |
| Practice Telephone | 2077957575 |
| Practice Fax Number | 2077957133 |
| Mailing Telephone | 2077957575 |
| Mailing Fax Number | 2077957133 |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP171007 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255787594 | Diana Yashieka Jackson | Licensed Practical Nurse | 973 Portland Ave, Downstairs, Rochester, NY 14621-4165 | 2016-05-05 |
| 1225449499 | Diana Jackson | Licensed Practical Nurse | 5582a Zapata Dr, Pegram, TN 37143-2300 | 2014-05-09 |
| 1962631424 | Diana Jackson | Licensed Practical Nurse | 6628 Crescent Grn, West Bloomfield, MI 48322-1325 | 2009-07-06 |
| 1225247752 | Diana Dean Jackson | Specialist | 6133 Elm Ln, Matteson, IL 60443-1321 | 2007-05-22 |
| 1902405004 | Diana Lynn Jackson | Technician | 409 Spring Ave, Moorefield, WV 26836-1036 | 2020-10-20 |
| 1902352412 | Diana Sue Jackson | Counselor | 1744 2nd Ave Se, Cedar Rapids, IA 52403-2306 | 2016-08-25 |
| 1417378787 | Diana Beltran Jackson | Speech-Language Pathologist | 3355 Boca Chica Blvd, Suite 8, Brownsville, TX 78521-4201 | 2014-01-03 |
| 1942423959 | Diana Jackson | Counselor | 19 E 6th St, Tracy, CA 95376-4107 | 2007-04-10 |
| 1083837843 | Diana Marie Jackson | Nurse Practitioner | 1025 Pennock Pl, Fort Collins, CO 80524-3257 | 2007-04-10 |
| Street Address |
300 MAIN ST |
| City | LEWISTON |
| State | ME |
| Zip Code | 04240-7027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700492865 | Maya K Ahluwalia | Physical Therapist | 300 Main St, Lewiston, ME 04240-7027 | 2020-09-23 |
| 1811519788 | Daniel Shaw | Dietitian, Registered | 300 Main St, Lewiston, ME 04240-7027 | 2020-05-13 |
| 1801427232 | Denise Tso | Physical Therapist | 300 Main St, Lewiston, ME 04240-7027 | 2020-02-04 |
| 1548891237 | Ellen Shrader | Dietitian, Registered | 300 Main St, Lewiston, ME 04240-7027 | 2020-01-31 |
| 1588295828 | Allison Bruno | Dietitian, Registered | 300 Main St, Lewiston, ME 04240-7027 | 2020-01-27 |
| 1578119335 | Chelsea Brown | Physician Assistant | 300 Main St, Lewiston, ME 04240-7027 | 2019-08-16 |
| 1316506017 | Joshua Robert Browning | Physician Assistant | 300 Main St, Lewiston, ME 04240-7027 | 2019-06-07 |
| 1457813313 | Jennifer Dewilde Caswell | Occupational Therapist | 300 Main St, Lewiston, ME 04240-7027 | 2019-04-01 |
| 1124592621 | Emile Thomas Castonguay | Occupational Therapist | 300 Main St, Lewiston, ME 04240-7027 | 2019-01-17 |
| 1841763182 | Macey Nicole Berube | Physical Therapist | 300 Main St, Dept of Physical Therapy, Lewiston, ME 04240-7041 | 2019-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773882 | Hannah Page Guerrette | Speech-Language Pathologist | 2 Strawberry Ave, Lewiston, ME 04240 | 2020-09-03 |
| 1497392500 | Samuel C Larouche | Social Worker | 100 Campus Ave Stes A&b, Lewiston, ME 04240 | 2019-12-09 |
| 1972145019 | Pomarand Behavioral Services | Nurse Practitioner | 217 Main St., Suite 201, Lewiston, ME 04240 | 2019-10-10 |
| 1396248258 | William Bucklin | Counselor | 17 Main St Fl 2, Lewiston, ME 04240 | 2018-03-16 |
| 1548769524 | Kevin Ryan | Physician Assistant | 12 High Street Suite 102, Lewiston, ME 04240 | 2018-02-06 |
| 1033637673 | Wellness Center | Clinic/Center | 37 Park Street, Suite 305, Lewiston, ME 04240 | 2017-09-04 |
| 1710404561 | Colasante Chiropractic, LLC | Clinic/Center | 184 Webster Street, #100, Lewiston, ME 04240 | 2017-08-23 |
| 1609398544 | Lindsey Laforge | Occupational Therapist | 984 1/2 Sabattus Street, Lewiston, ME 04240 | 2017-07-12 |
| 1861922478 | Seth Toothaker | Counselor | 1190 Lisbon Street, Lewiston, ME 04240 | 2017-06-15 |
| 1861850828 | Black Bear Support Services, LLC | Community/Behavioral Health | 571 Sabattus Street, Suite 15, Lewiston, ME 04240 | 2016-02-05 |
| Find all providers in zip 04240 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831746239 | Amanda Adams | Nurse Practitioner | 5226 Walmore Rd, Lewiston, NY 14092-9733 | 2019-08-20 |
| 1891258182 | Tamara Dawn Demean | Nurse Practitioner | 1331 G St, Lewiston, ID 83501-1964 | 2019-04-12 |
| 1518436450 | Sokharath Keller | Nurse Practitioner | 12 High St Ste 302, Lewiston, ME 04240-7690 | 2018-11-21 |
| 1982170403 | Sara Denoncourt | Nurse Practitioner | 99 Campus Ave Ste 301, Lewiston, ME 04240-6045 | 2018-10-23 |
| 1659877637 | Donna Poirier | Nurse Practitioner | 733 Center St, Lewiston, NY 14092-1705 | 2018-03-30 |
| 1972013852 | Katelyn Marie Rock | Nurse Practitioner | 10 High St Ste 305, Lewiston, ME 04240-7656 | 2017-10-05 |
| 1518327576 | Lauren Blais | Nurse Practitioner | 77 Bates St Ste 201, Lewiston, ME 04240-7637 | 2016-03-03 |
| 1073983748 | Tracy Streibick Flynn | Nurse Practitioner | 500 8th Ave Rm 205, Lewiston, ID 83501-2691 | 2015-10-06 |
| 1679963284 | Amy Lynette Larson | Nurse Practitioner | 338 6th St # 101, Lewiston, ID 83501-2420 | 2015-02-03 |
| 1679989222 | Stephanie Mellen | Nurse Practitioner | 330 Sabattus St Ste B, Lewiston, ME 04240-5553 | 2014-07-03 |
| Find all providers in LEWISTON | ||||
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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.