ANDREA JACKSON (NPI# 1912411133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912411133 |
| Entity Type | Individual |
| Full Name | ANDREA JACKSON |
| Practice Address |
52 Hillside Ave Freeport NY 11520-1726 |
| Practice Telephone | 5164515257 |
| Mailing Telephone | 5164515257 |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 258201 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568948479 | Andrea M Jackson | Behavioral Analyst | 2091 Business Center Dr Ste 150, Irvine, CA 92612-1167 | 2018-07-13 |
| 1437670114 | Andrea Jackson | Nurse Practitioner | 406 W S Jordan Pkwy, South Jordan, UT 84095-3965 | 2017-07-03 |
| 1679003099 | Andrea Jackson | Social Worker | 306 Popula Blvd, Wappingers Falls, NY 12590-5712 | 2017-06-18 |
| 1578927638 | Andrea Jackson | Licensed Practical Nurse | 1617 Woodbine Ave Se, Warren, OH 44484-4964 | 2016-04-05 |
| 1649606617 | Andrea Jeanine Jackson | Social Worker | 2036 Wood St, Muskegon, MI 49444-1153 | 2013-09-22 |
| 1225371651 | Andrea Latrell Jackson | Social Worker | 10610 N 30th St, Apt. 46h, Tampa, FL 33612-6458 | 2013-04-04 |
| 1124383765 | Andrea Luthelle Jackson | Counselor | 1501 Nw 34th St, Oklahoma City, OK 73118-3203 | 2012-07-10 |
| 1457622656 | Andrea Jasmine Jackson | Behavioral Analyst | 7715 Nw 48 St, Suite B360, Miami, FL 33166 | 2012-01-19 |
| 1306140876 | Andrea Bessie Jackson | Case Manager/Care Coordinator | 6030 S May Ave Apt 451, Oklahoma City, OK 73159-1410 | 2010-12-27 |
| 1578707204 | Andrea Denise Jackson | Dentist | 6912 Wade Ave, Clinton, MD 20735-2743 | 2009-04-24 |
| Street Address |
52 HILLSIDE AVE |
| City | FREEPORT |
| State | NY |
| Zip Code | 11520-1726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881157154 | Barbara Chillemi | Registered Nurse | 56 Mackay Place, Freeport, NY 11520 | 2019-04-12 |
| 1588171631 | Lisa Frank | Nurse Practitioner | 150 Buffalo Ave, Freeport, NY 11520 | 2018-01-10 |
| 1447775838 | Julner Quettant Jr. | Physical Therapist | 63 St Marks Ave, Freeport, NY 11520 | 2017-08-07 |
| 1679003933 | Candice A R Greene | Speech-Language Pathologist | 12 Summers Place, Freeport, NY 11520 | 2017-06-19 |
| 1700310331 | Samantha Edwards | Psychologist | 6 Delisle Avenue, Freeport, NY 11520 | 2017-04-20 |
| 1275073769 | Dorothea Geiger | Behavior Technician | 90 Hillside Ave, Freeport, NY 11520 | 2017-03-02 |
| 1477092575 | Maryhaven Center of Hope,inc | Substance Abuse Rehabilitation Facility | 150 Buffalo Avenue, Freeport, NY 11520 | 2017-02-22 |
| 1861849135 | Daniel Lora | Acupuncturist | 140 Parsons Ave, Freeport, NY 11520 | 2016-05-17 |
| 1326413790 | Beatrice Jeanty | Registered Nurse | 619 South Long Beach Ave., Freeport, NY 11520 | 2015-12-10 |
| 1134505548 | Maria A. Meek | Nurse Practitioner | 334, West Merrick Rd., Freeport., NY 11520 | 2015-08-07 |
| Find all providers in zip 11520 | ||||
| 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 |
|---|---|---|---|---|
| 1457963084 | Rachael Boafo | Licensed Practical Nurse | 306 Cherry St, Freeport, MI 49325-9655 | 2020-08-17 |
| 1063041663 | Tangala Sue Montgomery | Licensed Practical Nurse | 19253 Sligo Rd, Freeport, OH 43973-9660 | 2020-04-06 |
| 1295205086 | Miguelina Magarin | Licensed Practical Nurse | 160 Guy Lombardo Ave Apt 4e, Freeport, NY 11520-4409 | 2018-12-05 |
| 1750875175 | Keisha A Huie | Licensed Practical Nurse | 79 Ray Avenue, Freeport, NY 11520-1481 | 2018-06-19 |
| 1386178143 | Evelyn Richardson | Licensed Practical Nurse | 3 Laurel Rd, Freeport, NY 11520-5112 | 2017-04-18 |
| 1932631926 | Maxine Saunders | Licensed Practical Nurse | 16 Beverly Pkwy, Freeport, NY 11520-2002 | 2017-03-30 |
| 1366989717 | Ruth Exhume-mervil | Licensed Practical Nurse | 70 Stevens St, Freeport, NY 11520-1219 | 2017-01-24 |
| 1477097582 | Phana Romulus | Licensed Practical Nurse | 150 N Brookside Ave, Freeport, NY 11520-1931 | 2016-12-08 |
| 1619337615 | Taneisha Dunbar | Licensed Practical Nurse | 97 Dehnhoff Ave, Freeport, NY 11520-2304 | 2016-03-03 |
| 1720450455 | Cassandra Thomas | Licensed Practical Nurse | 152 Westside Ave, Freeport, NY 11520-6025 | 2015-10-21 |
| Find all providers in FREEPORT | ||||
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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.