Allison Nicole Jacks, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

341533 Issued in TX

Practice address

4750 FM 1196
San Augustine, TX 75972-5433

Phone

(936) 201-3374

NPI assigned

Jan 22, 2020

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1154951853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 FM 1196",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759725433",
            "telephone_number": "936-201-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "ALLISON",
        "middle_name": "NICOLE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "341533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wingett Harley Goodwin, DDS
• Chivas Paul Guillote, APRN, FNP, AGACNP
• Health Opportunities for the People of East Texas, Inc. (Hope Pharmacy San Augustine)
• Hopkins County Hospital District (Stonecreek Nursing & Rehabilitation)
• Rebecca Hubbard, LAT, ATC
• Jeannine Cullum DDS, PLLC
• John H III & Sharon Oglesbee
• Konstant Kontact Services LLC
• Gregory Landerman
• Lisa Michelle Lane

• Licensed Vocational Nurse in San Augustine, TX
• Providers in San Augustine, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.