Active NPI
Marquita M Jackson, RN
- School Registered Nurse
- Clinton, LA
National Provider Identifier
1336378140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- RN112654
- Practice address
- 11990 Jackson St.
Clinton, LA 70722 - Phone
- (225) 683-5292
- NPI assigned
- Jul 14, 2009
- Last updated
- Jul 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | RN112654 | LA | Primary |
Addresses
Primary practice location
11990 Jackson St.
Clinton, LA 70722
Mailing address
4506 Highway 952
Jackson, LA 70748-3130
Phone (225) 454-5283
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 |
|---|---|---|---|
| RN112654 | LA | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247529600000",
"number": "1336378140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4506 HIGHWAY 952",
"city": "JACKSON",
"state": "LA",
"postal_code": "707483130",
"telephone_number": "225-454-5283",
"fax_number": "225-683-4354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11990 JACKSON ST.",
"city": "CLINTON",
"state": "LA",
"postal_code": "70722",
"telephone_number": "225-683-5292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARQUITA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-14",
"last_updated": "2009-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "LA",
"license": "RN112654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.