Serida Marie Jackson, LPN
Licensed Practical Nurse in Valley Stream, NY. Individual provider (NPI-1).
NPI number1154841120
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1154841120
- Entity type
- Individual (NPI-1)
- Name
- Ms. Serida Marie Jackson
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 328081 | NY | Yes |
Practice location
106 Countisbury AveValley Stream, NY 11580-1748
Phone 516-270-0943
Mailing address
106 Countisbury AveValley Stream, NY 11580-1748
Phone 516-270-0943
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All 152 Licensed Practical Nurse providers in Valley Stream · All 2,560 providers in Valley Stream
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