Sharon Anne Jackson, LPN
Individual provider Active NPI Licensed Practical Nurse · Hogansburg, NY
NPI 1124504683 · NPPES record last updated Jul 17, 2018
Key facts
- NPI
- 1124504683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 179948-1 (NY)
- Practice address
- 404 State Route 37
Hogansburg, NY 13655 - Phone
- (518) 358-3141
- Fax
- (518) 358-9175
- NPI assigned
- Jul 17, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 179948-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 179948-1 | NY | Yes |
Addresses
Primary practice location
404 State Route 37
Hogansburg, NY 13655
Mailing address
404 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141
Other providers in Hogansburg, NY
- Jesalyn Marie Hayes
- Katherine R Henderson
- Mary M Herne
- Hillary Pyke
- Louise D Ingle
- Kawenniio Jamaica Johnson
- Trish D Keese
- Zenas Kuate Defo
- Nancy J Labarge
- William R Latreille Jr.
All providers in Hogansburg, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.