Active NPI
Valencia Denise Jackson, RN
- School Registered Nurse
- Los Lunas, NM
National Provider Identifier
1053829135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- RN-70128
- Practice address
- 46 Chacon Rd.
Los Lunas, NM 87031 - Phone
- (505) 865-1102
- Fax
- (505) 865-8995
- NPI assigned
- Jan 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | RN-70128 | NM | Primary |
Addresses
Primary practice location
46 Chacon Rd.
Los Lunas, NM 87031
Mailing address
46 Chacon Rd.
Los Lunas, NM 87031
Phone (505) 865-1102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN-70128 | NM | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1053829135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 CHACON RD.",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "87031",
"telephone_number": "505-865-1102",
"fax_number": "505-865-8995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 CHACON RD.",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "87031",
"telephone_number": "505-865-1102",
"fax_number": "505-865-8995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "VALENCIA",
"middle_name": "DENISE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-11",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NM",
"license": "RN-70128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Lunas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.