Tameatrice Michelle Jackson, RN/CRT

Primary specialty

Religious Nonmedical Nursing PersonnelTaxonomy code 374T00000X

License

RN9255446 Issued in FL

Practice address

2506 Chestnut Springs LN
Jacksonville, FL 32246-1323

Phone

(904) 382-1793

Fax

(904) 253-6759

NPI assigned

May 16, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1386801421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 CHESTNUT SPRINGS LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322461323",
            "telephone_number": "904-382-1793",
            "fax_number": "904-253-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 CHESTNUT SPRINGS LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322461323",
            "telephone_number": "904-382-1793",
            "fax_number": "904-253-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMEATRICE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "RN/CRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374T00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Nursing Personnel",
            "state": "FL",
            "license": "RN9255446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693464196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shontae D Jackson
• Stacie Jackson, PA
• Steven Marc Jackson, PT
• Sydney Jackson
• Sylvia H Jackson, PHARMD
• Tasheka B Jackson
• Theresa E. Jackson
• Theresa Y Jackson, LMT
• Tiffany C Jackson, LMT
• Trichina Shalee Jackson

• Religious Nonmedical Nursing Personnel in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Religious Nonmedical Nursing Personnel in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.