Stephanie Jackson, Lpn
Licensed Practical Nurse in Medford, NY. Individual provider (NPI-1).
NPI number1548601511
StatusActive
Last updated in NPPESJul 8, 2013
Details
- NPI
- 1548601511
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Jackson
- Credential
- Lpn
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 8, 2013
- Last updated
- Jul 8, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 264400 | NY | Yes |
Practice location
39 W. Yaphank Rd.Medford, NY 11763
Phone 631-320-3077
Mailing address
39 W. Yaphank Rd.Medford, NY 11763
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All 89 Licensed Practical Nurse providers in Medford · All 733 providers in Medford
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