Laverne L. Jackson, RN,ICADC

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN158642 Issued in GA

Practice address

977A Taylor St SW
Conyers, GA 30012-5357

Phone

(770) 918-6677

NPI assigned

Dec 15, 2006

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295897189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 DELPHINE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300323927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977A TAYLOR ST SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125357",
            "telephone_number": "770-918-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAVERNE",
        "middle_name": "L.",
        "credential": "RN,ICADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "RN158642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Stefani Isaacson, D.C.
• Adekemi Abosede Ishola, MD, MBA
• George Isshak, M.D.
• Jacek Lyszkowicz MD PC
• Neda Marie Jackson Lawson, APRN, FNP-C
• Litiki Jackson
• Robert Jackson
• Yolande Jackson, NP
• Neahriah Jael, RN
• James Proctor DDS PC

• Community Health Registered Nurse in Conyers, GA
• Providers in Conyers, GA by specialty
• Community Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.