DR. LETITIA JACKSON (NPI# 1790304681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790304681 |
| Entity Type | Individual |
| Full Name | DR. LETITIA JACKSON |
| Credential | MD |
| Practice Address |
1023 Medical Center Pkwy Ste 200 Selma AL 36701-7739 |
| Practice Telephone | 3348754184 |
| Mailing Telephone | 3348754184 |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2020-04-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063812634 | Letitia Lynn Jackson | Nurse Practitioner | Rr 2 Box 317, Marlow, OK 73055-9675 | 2014-09-02 |
| 1053653857 | Letitia La'dawne Jackson | Licensed Practical Nurse | 1078 Billie Dr, Columbus, OH 43227-1402 | 2013-03-20 |
| 1962651703 | Letitia Jackson | Counselor | 13731 E Rice Pl Ste 200, Aurora, CO 80015-1077 | 2008-09-17 |
| Street Address |
1023 MEDICAL CENTER PKWY STE 200 |
| City | SELMA |
| State | AL |
| Zip Code | 36701-7739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578525291 | Tiffani N Maycock | Family Medicine | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2006-04-06 |
| 1154949543 | Munazzah Abdullah | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-07-11 |
| 1740804848 | Diedra Michelle Joseph Baker | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-06-04 |
| 1093335945 | Sheriff Olufemi Shittu | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-04-21 |
| 1063032969 | Christopher Reyes Caangay | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-04-21 |
| 1023592045 | Tacarla Shantese Pearson | Nurse Practitioner | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2018-09-17 |
| 1508316019 | Nishant Sharma | Family Medicine | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-6780 | 2016-10-07 |
| 1972766095 | Eric Boyd Wells | Family Medicine | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2008-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114491057 | Monica Boswell Moore | Nurse Practitioner | 1015 Medical Center Parkway, Selma, AL 36701 | 2019-01-14 |
| 1649784430 | Lightfoot Chiropractic Clinic, LLC | Chiropractor | 2117 Broad Street, Selma, AL 36701 | 2017-12-01 |
| 1356883284 | Vatausha Howard | Counselor | 1017 Medical Center Parkway, Selma, AL 36701 | 2016-11-09 |
| 1366993230 | Homestead Hospice of Cahaba | Hospice, Inpatient | 3005 Citizens Parkway, Selma, AL 36701 | 2016-10-17 |
| 1497018675 | Lashana Faye Jones | Technician | 2423 A North Broad St, Selma, AL 36701 | 2012-06-21 |
| 1528222809 | Eric M. Roussell Sr. | Pharmacist | 1300 Highland Avenue, Selma, AL 36701 | 2008-07-15 |
| 1144499302 | Cecil William Fuller Sr. | Dentist | 203 Dallas Ave, Selma, AL 36701 | 2008-02-21 |
| 1184813396 | Alliance Pharmacy LLC | Pharmacy | 133 1half Broad St, Selma, AL 36701 | 2007-10-24 |
| 1376740373 | Selma City | Local Education Agency (LEA) | 2194 Broad Street, Selma, AL 36701 | 2007-07-02 |
| 1245356229 | Georgia W Rhodes | Audiologist | 2906 Citizens Pkwy, Selma, AL 36701 | 2007-03-22 |
| Find all providers in zip 36701 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407468689 | Yasmeen Antheana-neshaygreen Brenson | Student in an Organized Health Care Education/Training Program | 206 Lakeview Ave, Selma, AL 36703-1705 | 2020-08-19 |
| 1245799550 | Jose David Orozco | Student in an Organized Health Care Education/Training Program | 13661 S Van Horn Ave, Selma, CA 93662-9475 | 2019-03-16 |
| 1629351291 | Kamarn Toqeer Ahmad | Student in an Organized Health Care Education/Training Program | 1023 Med Ctr Pkwy Ste 200, Selma, AL 36701-7739 | 2011-09-21 |
| 1982203329 | Amanda Dawn Atcheson | Student in an Organized Health Care Education/Training Program | 1015 Medical Center Pkwy, Selma, AL 36701-6748 | 2020-10-17 |
| 1154949543 | Munazzah Abdullah | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-07-11 |
| 1740804848 | Diedra Michelle Joseph Baker | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-06-04 |
| 1093335945 | Sheriff Olufemi Shittu | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-04-21 |
| 1063032969 | Christopher Reyes Caangay | Student in an Organized Health Care Education/Training Program | 1023 Medical Center Pkwy Ste 200, Selma, AL 36701-7739 | 2020-04-21 |
| 1962032482 | Benjamin Lamar Jones | Student in an Organized Health Care Education/Training Program | 15 Deerfield Rd, Selma, AL 36701-8339 | 2020-01-23 |
| 1316598279 | John Thomas Nichols | Student in an Organized Health Care Education/Training Program | 1015 Medical Center Pkwy, Selma, AL 36701-6748 | 2019-09-23 |
| Find all providers in SELMA | ||||
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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.