CHARLENE JACKSON (NPI# 1689994683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689994683 |
| Entity Type | Individual |
| Full Name | CHARLENE JACKSON |
| Practice Address |
2075 Ripley St Lake Station IN 46405-1161 |
| Mailing Address |
1063 Wallace St Gary IN 46404-1818 |
| Practice Telephone | 2199629437 |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2010-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 27031267A | IN | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487105458 | Charlene Rene Jackson | Technician, Other | 18029 Stephens Dr, Eastpointe, MI 48021-1810 | 2016-10-14 |
| 1073919379 | Charlene Jackson | Case Manager/Care Coordinator | 236 1/2 W 57th St, Los Angeles, CA 90037-4199 | 2014-11-13 |
| 1528174109 | Charlene Dawn Jackson | Kinesiotherapist | 1 Freedom Way # 294, Augusta, GA 30904-6258 | 2006-08-23 |
| 1093321838 | Charlene Jackson | Community Health Worker | 202 E Bagley Rd, Berea, OH 44017-2058 | 2020-09-17 |
| 1134759855 | Charlene Marie Jackson | Early Intervention Provider Agency | 1000 W Broadway St Ste 214, Oviedo, FL 32765-9262 | 2020-01-22 |
| 1245419472 | Charlene Marie Jackson | Technician | 800 Scenic Dr, Modesto, CA 95350-6131 | 2007-10-24 |
| 1417073552 | Charlene J. Jackson | Physical Therapist | 416 W 27th St, Ashtabula, OH 44004-4975 | 2007-03-21 |
| Street Address |
2075 RIPLEY ST |
| City | LAKE STATION |
| State | IN |
| Zip Code | 46405-1161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972637171 | Southlake Tricity Rba | Custodial Care Facility | 2075 Ripley St, Lake Station, IN 46405-1161 | 2007-03-16 |
| 1699043190 | Jennifer Marie Legg | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2011-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245507748 | Melissa Goldsberry | Pharmacist | 9500 Central Avenue, Lake Station, IN 46405 | 2011-11-28 |
| 1518085992 | Nikki A Wargo Dds | Dentist | 2370 E 37th Ave, Lake Station, IN 46405 | 2007-03-26 |
| 1336214493 | Civil City of Lake Station Ind | Ambulance | 1876 Fairview Ave, Lake Station, IN 46405 | 2006-11-22 |
| 1720511785 | Patience Tieri | Nurse Practitioner | 2490 Central Ave, Lake Station, IN 46405 | 2017-04-06 |
| 1982041893 | Nanette Lindesmith | Nurse Practitioner | 3304 Parkside Ave, Lake Station, IN 46405 | 2013-05-31 |
| 1639249212 | Maria Rosario Badar | Internal Medicine | 3820 Central Ave, Lake Station, IN 46405 | 2006-11-09 |
| 1972895647 | Northshore Health Centers, Inc. | Family Medicine | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2011-05-12 |
| 1215289186 | Kari Payton | Specialist/Technologist | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2012-10-02 |
| 1497995815 | Northshore Health Centers, Inc. | Pharmacy | 2490 Central Ave Ste B, Lake Station, IN 46405-2122 | 2009-02-25 |
| 1578563516 | Shah Alam Chowdhury | Pediatrics | 2490 Central Ave, Lake Station, IN 46405-2122 | 2005-07-29 |
| Find all providers in zip 46405 | ||||
| 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 |
|---|---|---|---|---|
| 1699043190 | Jennifer Marie Legg | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2011-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083455 | Tara Higgins | Licensed Practical Nurse | 4063 Presidio Cir, Indianapolis, IN 46235-9000 | 2020-11-08 |
| 1487265161 | Sherry Lynn Mcneely | Licensed Practical Nurse | 1296 N Gardner St, Scottsburg, IN 47170-1400 | 2020-08-14 |
| 1124652839 | Kimberly Nicole Brown | Licensed Practical Nurse | 6208 Raleigh Dr, Indianapolis, IN 46219-1623 | 2020-03-03 |
| 1326671967 | L'tia Lewis | Licensed Practical Nurse | 4608 Hawkeye Ct, Indianapolis, IN 46254-5920 | 2020-02-21 |
| 1346880341 | Demetrius Whitehead | Licensed Practical Nurse | 415 S Butler Ave, Indianapolis, IN 46219-7034 | 2020-01-08 |
| 1619522679 | Kamiaha Pinner | Licensed Practical Nurse | 11120 Fall Dr, Indianapolis, IN 46229-1969 | 2019-08-07 |
| 1407418817 | Kelli Ann Howard | Licensed Practical Nurse | 4324 Wimbleton Ct Apt B, South Bend, IN 46637-4053 | 2019-07-05 |
| 1912566498 | Patrick Thomas James | Licensed Practical Nurse | 12170 S State Road 3, Muncie, IN 47302-8793 | 2019-06-10 |
| 1033774690 | Deedee Wilfong | Licensed Practical Nurse | 708 E Bradford St, Marion, IN 46952-2959 | 2019-05-08 |
| 1437712916 | Shanetta Denise Savado | Licensed Practical Nurse | 717 S 29th St, South Bend, IN 46615-2237 | 2019-04-19 |
| Find all providers with the same taxonomy | ||||
| City | LAKE STATION |
| Zip Code | 46405 |
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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.