Jacklene Jackson, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

201242738RN Issued in OR

Practice address

1270 Kot-Num Rd.
Warm Springs, OR 97761

Phone

(541) 553-1196

NPI assigned

Feb 22, 2017

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

Other names 1

• Jacklene Light Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: jaklene.jackson.p2@direct.lanecounty.nextgenshare.com

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1386183416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX C",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "977613001",
            "telephone_number": "541-553-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOT-NUM RD.",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "97761",
            "telephone_number": "541-553-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACKLENE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "201242738RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKLENE",
            "last_name": "LIGHT",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louella Marie Heath
• Frank Charles Hoffman, MD
• Elsie B Howard, RN
• Brenda Lu Howe, MSN-NED, PHN, RN
• Barbara Ann Ibrahim, RN
• Sapna Jain, M.D.
• Elizabeth Johnson, RN
• Patricia Mary Kelly, RN
• Natalie Ann Kiefer, DPT
• Jeri C Kollen, RN

• Community Health Registered Nurse in Warm Springs, OR
• Providers in Warm Springs, OR by specialty
• Community Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.