Narlene Lucita Jackson, LPN

Individual provider Active NPI Licensed Practical Nurse · Catawba, SC

NPI 1114230646 · NPPES record last updated Jul 26, 2010

Key facts

NPI
1114230646
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
P39095 (SC)
Practice address
753 Sidney Cornwell CT
Catawba, SC 29704-7782
Phone
(803) 448-0469
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P39095SCMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P39095 SC Yes

Addresses

Primary practice location

753 Sidney Cornwell CT
Catawba, SC 29704-7782

Mailing address

753 Sidney Cornwell CT
Catawba, SC 29704-7782
Phone (803) 448-0469

Other providers in Catawba, SC

All providers in Catawba, SC · Licensed Practical Nurse in South Carolina

Sources for this page

Verify at the official NPI Registry.