DIANA JACKSON (NPI# 1962631424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962631424 |
| Entity Type | Individual |
| Full Name | DIANA JACKSON |
| Credential | L.P.N. |
| Practice Address |
6628 Crescent Grn West Bloomfield MI 48322-1325 |
| Practice Telephone | 2485929803 |
| Mailing Telephone | 2485929803 |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703092206 | MI | Nursing Service 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 |
| 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 |
| 1417498007 | Diana Jackson | Nurse Practitioner | 300 Main St, Lewiston, ME 04240-7027 | 2017-03-15 |
| 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 |
6628 CRESCENT GRN |
| City | WEST BLOOMFIELD |
| State | MI |
| Zip Code | 48322-1325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483492 | Life Saver Home Health, LLC | Home Health | 6436 Silverbrooke, West Bloomfield, MI 48322 | 2020-10-06 |
| 1316557374 | Gabrielle Benaderet | Speech-Language Pathologist | 6548 Heritage, West Bloomfield, MI 48322 | 2020-08-05 |
| 1437774197 | Madeline Gail Tenenbaum | Social Worker | 6800 W. Maple Rd., West Bloomfield, MI 48322 | 2020-06-09 |
| 1639705676 | Stephanie Cole | Social Worker | 5749 Crossgate, West Bloomfield, MI 48322 | 2020-03-22 |
| 1407409709 | Laura Elizabeth Large | Social Worker | Couseling Associates, Inc., 6960 Orchard Lake Rd. Ste. 100, W. Bloomfield, MI 48322 | 2019-07-17 |
| 1144796533 | Jaleesa Davis | Home Health Aide | 6436 Silverbrook W, West Bloomfield, MI 48322 | 2018-10-23 |
| 1912484411 | Mjl Therapy Pllc | Clinic/Center | 5745 West Maple Road Suite 213, West Bloomfield, MI 48322 | 2018-07-26 |
| 1396247847 | Martha Gomez-pedraza | Physical Therapist | 6200 Orchard Lake Rd - Suite Ll9, West Bloomfield, MI 48322 | 2018-03-01 |
| 1659872174 | Jennifer Marie O'connor | Physical Therapist | Beaumont Medical Center West Bloomfield, 6900 Orchard Lake Rd., Suite Ll09, West Bloomfield, MI 48322 | 2018-02-21 |
| 1851890834 | Naomi Marie Lang | Physical Therapy Assistant | 6535 Drake Rd. West, Bloomfield Township, MI 48322 | 2018-02-06 |
| Find all providers in zip 48322 | ||||
| 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 |
|---|---|---|---|---|
| 1720576838 | Rio Prewitt | Licensed Practical Nurse | 5088 Silverwood Dr, West Bloomfield, MI 48322-3373 | 2018-04-24 |
| 1306389747 | Gregory Robertson | Licensed Practical Nurse | 6815 Brockhurst Blvd, West Bloomfield, MI 48322-1270 | 2016-12-01 |
| 1699129346 | Alindria Jones | Licensed Practical Nurse | 7418 Sauterne St, West Bloomfield, MI 48322-2863 | 2016-04-19 |
| 1699131128 | Vanessa Green | Licensed Practical Nurse | 4370 Crestdale Ave, West Bloomfield, MI 48323-1131 | 2016-01-13 |
| 1144695503 | Dixie Douglas | Licensed Practical Nurse | 5836 Applewood, West Bloomfield, MI 48322-3484 | 2015-12-09 |
| 1154792026 | Christopher Sykes | Licensed Practical Nurse | 6211 Andrea Ln, West Bloomfield, MI 48322-2122 | 2015-10-16 |
| 1598157042 | Catina Garrison | Licensed Practical Nurse | 6266 Silverbrook W, West Bloomfield, MI 48322-1029 | 2015-02-20 |
| 1407245764 | Regina Dukes | Licensed Practical Nurse | 6135 Silverbrook W, West Bloomfield, MI 48322-1016 | 2015-01-09 |
| 1396089546 | Tasha M Davis | Licensed Practical Nurse | 6885 Scotch Lake Dr, West Bloomfield, MI 48324-3984 | 2012-11-11 |
| 1265606594 | Terry Hall-heaphy | Licensed Practical Nurse | 7806 Detroit Blvd, West Bloomfield, MI 48323-1025 | 2008-04-17 |
| Find all providers in WEST BLOOMFIELD | ||||
| City | WEST BLOOMFIELD |
| Zip Code | 48322 |
Please comment or provide details below to improve the information on DIANA JACKSON.
| 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.