LISA NICOLE JACKSON (NPI# 1720493224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720493224 |
| Entity Type | Individual |
| Full Name | LISA NICOLE JACKSON |
| Credential | B.A. SLPA |
| Practice Address |
3200 Troup Hwy Ste, 120 Tyler TX 75701 |
| Mailing Address |
3200 Troup Hwy Ste 120 Tyler TX 75701-8364 |
| Practice Telephone | 9032530095 |
| Mailing Telephone | 9032530095 |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
37923 | TX | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| 1659980738 | Lisa Ann Jackson | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2020-07-24 |
| Street Address |
3200 TROUP HWY STE, 120 |
| City | TYLER |
| State | TX |
| Zip Code | 75701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129052 | Kandis Cozart | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2020-09-16 |
| 1134741952 | Cinthia Ramirez | Specialist/Technologist | 9846 State Highway 31 E, Tyler, TX 75705-2329 | 2020-05-14 |
| 1184258618 | Veronica Hunter | Specialist/Technologist | 9846 Highway 31 E, Tyler, TX 75705-2329 | 2020-02-24 |
| 1972148898 | Rachel Young | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-11-14 |
| 1649815663 | Margaret Kunze | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-11-13 |
| 1689219602 | Heather Hammond | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-11-13 |
| 1275178287 | Laura Chacon | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-11-13 |
| 1609411636 | Helen Whetstone | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-11-13 |
| 1285292656 | Myra Barnes | Specialist/Technologist | 921 Shiloh Rd Ste C120, Tyler, TX 75703-1407 | 2019-05-31 |
| 1740847904 | Tyra Henderson | Specialist/Technologist | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-05-23 |
| Find all providers in TYLER | ||||
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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.